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Are High-Risk Colon Polyps Linked to Higher Mortality From Liver Cancer?

By: Joshua Swore, PhD
Posted: Thursday, October 19, 2023

Findings published in Digestive and Liver Disease suggest there may be an increased risk for death as the result of liver malignancies in patients with specific colon polyps detected at screening colonoscopy. “Colorectal cancer shares with several hepatic malignancies the susceptibility to carcinogens such as a high body mass index, tobacco consumption, and excessive alcohol intake,” said Monika Ferlitsch, MD, of the Medical University of Vienna, and colleagues.

“Future studies will show whether risk stratification at screening colonoscopy is a useful tool to assign participants to other screening programs and whether an additional liver ultrasound is cost-effective in these participants,” concluded the investigators.

The retrospective study included data from 343,838 colonoscopies free of colon cancer conducted between 2007 and 2020. Patients were then stratified as either being at high or low risk. Patients were considered to be at high risk when screening revealed five or more adenomas and at least one with high-grade dysplasia, a polyp larger than 10 mm, or a serrated polyp with dysplasia. The authors then used the cumulative incidence method to assess risk for hepatobiliary cancer death and a Cox proportional hazard model to find an association with the time to death. 

The investigators reported that hepatobiliary cancer mortality rates were two times more frequent in patients with high-risk polyps (cumulative incidence, 0.39%; 95% confidence interval [CI] = 0.37%–0.41%) versus patients with a negative colonoscopy (cumulative incidence, 0.17%; 95% CI = 0.17%–0.17%). Furthermore, the authors found the presence of high-risk polyps was also associated with hepatobiliary cancer death after adjusting for age and sex. The findings led the authors to call for additional studies to determine screening methods for liver diseases and consecutive malignancies in an effort to benefit these high-risk patients.

Disclosure: For full disclosures of the study authors, visit

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