Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"August 12, 2026 3 min read Add topic to email alerts Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . ” data-action=subscribe> Subscribe We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: Cardiometabolic risk factor reduction was linked to lower risk for metachronous advanced colorectal neoplasia in patients with MASLD. Those with highest baseline risk benefited most from metabolic improvements. Patients with metabolic dysfunction-associated steatotic liver disease who improved their metabolic health after polypectomy significantly lowered their risk for metachronous advanced colorectal neoplasia, study results showed. Findings also suggested that those with the highest metabolic burden or any advanced colorectal neoplasia at baseline benefited most from lifestyle interventions to reduce this risk. \u201cPostpolypectomy care should extend beyond scheduling the next surveillance colonoscopy,\u201d Han-Mo Chiu, MD, PhD, attending physician and clinical professor in the department of internal medicine at National Taiwan University Hospital, told Healio. \u201cRather than asking patients to wait passively for the next examination, clinicians should actively encourage improvements in metabolic health during the surveillance interval. By addressing modifiable metabolic abnormalities, patients can take an active role in reducing their future risk of metachronous advanced neoplasia.\u201d Previous research has established a link between cardiometabolic risk factors (CMRFs) \u2014abdominal obesity, impaired fasting glucose, high blood pressure, hypertriglyceridemia and low HDL cholesterol \u2014 development of colorectal cancer, according to Chiu and colleagues. The risk for advanced colorectal neoplasia and CRC is even greater among those with MASLD, a condition defined by the presence of at least one of those risk factors. \u201cAlthough patients with MASLD are known to be at increased risk for colorectal neoplasia, it remains unclear whether MASLD also contributes to the future development of neoplasia after adenoma removal and \u2014 more importantly \u2014 what patients can do to mitigate this risk,\u201d Chiu said. \u201cCurrent postpolypectomy care largely consists of advising patients when to return for surveillance colonoscopy according to their colonoscopic finding and the corresponding recommended surveillance interval,\u201d he added. \u201cHowever, little is known about what interventions should be implemented during this interval to reduce the risk of metachronous neoplasia \u2014 that is, how to effectively integrate primary prevention into postpolypectomy care.\u201d Chiu and colleagues conducted a retrospective cohort study of 2,331 individuals aged 40 years and older (mean age, 56.7 years; 74.9% men) with MASLD who underwent initial and surveillance colonoscopy at National Taiwan University Hospital from 2009 to 2021. All participants had at least one colorectal adenoma removed during the initial procedure. Metachronous advanced colorectal neoplasia \u2014 an adenoma with a minimum diameter of 10 mm and villous components or high-grade dysplasia \u2014 served as the primary outcome. At mean follow-up of 4 years, incidence of metachronous neoplasia per 1,000 patient-years was not significantly different between patients with increased CMRF count (16.7; 95% CI, 11.4-23.6) and those whose count remained unchanged (17.6; 95% CI, 12.9-23.9). However, incidence significantly dropped among patients with a CMRF reduction of one (11.9; 95% CI, 8.3-16.4) or at least two (9.9; 95% CI, 5.8-15.7). Overall, any CMRF reduction was linked to significantly lower risk for metachronous advanced colorectal neoplasia (adjusted HR = 0.49; 95% CI, 0.33-0.73). Additional subgroup analyses found that among patients with five CMRFs at baseline, those with any reduction in count lowered their risk for neoplasia recurrence vs. those who did not reduce their count (aHR = 0.4; 95% CI, 0.17-0.92). Patients in another high-risk group \u2014 those with an advanced colorectal neoplasia at baseline \u2014 also lowered their risk by reducing their CMRF count (aHR = 0.27; 95% CI, 0.11-0.65). CMRF reductions were linked to lower prevalence of metachronous lesions at least 1 cm in diameter, as well. \u201cPatients with large adenomas at the index colonoscopy and those with the highest baseline metabolic burden \u2014 a baseline CMRF count of five \u2014 who achieved greater reductions in CMRF counts experienced the greatest reduction in recurrence risk,\u201d Chiu said. \u201cThese findings suggest that primary prevention after adenoma removal should move beyond a one-size-fits-all approach toward a strategy of precision prevention, targeting patients most likely to benefit from metabolic risk reduction.\u201d Study limitations included potential selection bias from excluding patients without follow-up data, possibility of missed external colonoscopy histories from the single-institution study design and reliance on point-in-time measurements of CMRFs. \u201cThe most important point in caring for patients with MASLD is that we do not have to fatalistically accept their elevated risk of metachronous advanced neoplasia \u2014 or even colorectal cancer \u2014 as inevitable,\u201d Chui said. \u201cInstead, we have an opportunity to actively reduce that risk by improving metabolic dysfunction, shifting postpolypectomy care from passive surveillance to proactive prevention.\u201d For more information: Han-Mo Chiu, MD, PhD, can be reached at hanmochiu@ntu.edu.tw. Published by: Ask a clinical question and tap into Healio AI’s knowledge base. PubMed, enrolling\/recruiting trials, guidelines Clinical Guidance, Healio CME, FDA news Healio’s exclusive daily news coverage of clinical data Learn more Add topic to email alerts Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . ” data-action=subscribe> Subscribe We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. 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