S283 The Association Between Pyogenic Liver Abscess and Increased Incidence of Colorectal Cancer Across Age Groups and in Patients With Diabetes Mellitus: A Meta-Analysis and Systematic Review

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Introduction: Pyogenic liver abscess (PLA) is a significant clinical condition with potential implications for colorectal cancer (CRC) incidence. Previous studies suggest a possible link between PLA and an increased risk of CRC, yet the relationship remains unclear. Our study aims to evaluate the incidence of CRC in patients with PLA, focusing on age-specific variations and the presence of diabetes mellitus. Methods: We did a comprehensive literature search using PubMed, EMBASE, and Cochrane Library, to identify studies reporting the incidence of CRC in patients with PLA. We included studies that compared the incidence of CRC in patients with and without PLA across different age groups and diabetes mellitus status. A random-effects model was used to pool effect sizes from the extracted data. The primary endpoint was the incidence of CRC. Results: We included 5 studies in our analysis including 39,631 patients. Our results exhibited a statistically significant higher incidence of CRC in patients with PLA across different age groups. Specifically, for patients under 60 years old, the pooled odds ratio (OR) was 3.83 (95% CI: 1.31 to 11.16) in patients with PLA compared to those without PLA (I2=0%; P =0.01). For patients over 60 years old, the pooled OR was 2.86 (95% CI: 1.23 to 6.65) in patients with PLA (I2=0%; P =0.01). The overall analysis for all age groups combined showed a pooled OR of 3.20 (95% CI: 1.65 to 6.20), with no significant heterogeneity (I2=0%; P =0.0006). For the incidence of CRC in patients with diabetes mellitus, the pooled OR was 1.48 (95% CI: 0.99 to 2.19), suggesting a non-significant trend toward a higher incidence of CRC in patients with diabetes mellitus (I2=4%; P =0.05). The overall incidence of CRC in patients with PLA showed a pooled OR of 3.16 (95% CI: 1.83 to 5.45), indicating a significantly higher incidence of CRC in these patients (I2=64%; P < 0.0001). Conclusion: This meta-analysis demonstrates a significant association between the presence of pyogenic liver abscess and the incidence of colorectal cancer across different age groups. The incidence is higher in both younger (< 60 years) and older (>60 years) patients with PLA. Although there is a trend towards increased CRC incidence in patients with diabetes mellitus, the association is not statistically significant. The overall analysis confirms a strong association between the presence of PLA and increased CRC incidence. However, further research is needed to explore the relationship between diabetes mellitus and CRC incidence more comprehensively (Figure 1).Figure 1.: Forest plot for A) Incidence of CRC with Age B) Incidence of CRC with diabetes mellitus C) Overall incidence of CRC.

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