Risk of Neoplasia After Colectomy in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-analysis  Lauranne A.A.P. Derikx, Loes H.C. Nissen, Lisa J.T. Smits, Bo Shen, Frank Hoentjen  Clinical Gastroenterology and Hepatology  Volume 14, Issue 6, Pages 798-806.e20 (June 2016) DOI: 10.1016/j.cgh.2015.08.042 Copyright © 2016 AGA Institute Terms and Conditions

Figure 1 Flowchart showing inclusion of articles for analysis. *Twelve articles are included in both the rectal stump group and the IRA group. #One article is included in both the IRA group and the IPAA group. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Figure 2 (A) Forest plot displaying effect of CRC before colectomy on development of rectal carcinoma after IRA. I2 (inconsistency) = 0%. (B) Forest plot displaying effect of CRC before colectomy on development of IPAA carcinoma. I2 (inconsistency) = 7.1%. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Figure 3 Summary chart of prevalence, incidence, and risk factors for colorectal neoplasia in the rectal stump, IRA, and IPAA. HR, hazard ratio; NS, not stated. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Figure 4 Pooled prevalences of carcinoma in the rectal stump, IRA, and IPAA groups when analyzed per 5-year mean or median duration of follow-up after colectomy. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 1 Forest plot displaying pooled carcinoma prevalence in the rectal stump of IBD patients. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 2 Forest plot displaying pooled carcinoma prevalence for IBD patients with IRA. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 3 Forest plot displaying pooled carcinoma prevalence for IBD patients with IPAA. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 4 Funnel plot analyzing publication bias of prevalence studies regarding rectal cancer in IBD patients with a rectal stump. Visual inspection of the funnel plot may indicate that some low prevalence studies are missing. Indeed, asymmetry of the plot is confirmed with the Egger test. However, because prevalence cannot extend below “0”, some asymmetry of the funnel plot may be expected. In addition, there are no outliers. Egger test: bias = 1.02 (95% CI, 0.05–2.00); P = .042. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 5 Funnel plot analyzing publication bias of prevalence studies regarding rectal cancer in IBD patients with IRA. Visual inspection of the funnel plot does not indicate publication bias, although the Egger test showed some asymmetry of the funnel plot. Many low prevalence studies are included contradicting publication bias. Egger test: bias = 0.79 (95% CI, 0.00–1.57); P = .049. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 6 Funnel plot analyzing publication bias of prevalence studies regarding pouch cancer in IBD patients with IPAA. Both visual inspection of the funnel plot and the Egger test showed no indication for publication bias. Egger test: bias = –0.14 (95% CI, –0.45 to 0.16); P = .346. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 7 Forest plot displaying effect of colorectal dysplasia before colectomy on development of IPAA neoplasia. I2 (inconsistency) = 0%. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 8 Forest plot displaying effect of type of anastomosis on development of IPAA carcinoma. I2 (inconsistency) = 0.1%. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 9 Forest plot displaying effect of type of anastomosis on development of IPAA neoplasia. I2 (inconsistency) = 0%. Clinical Gastroenterology and Hepatology 2016 14, 798-806.e20DOI: (10.1016/j.cgh.2015.08.042) Copyright © 2016 AGA Institute Terms and Conditions