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          This  meta-analysis has  several  limitations.  First,  the  total   System: The Role of Lymphotoxin and GALT Organs. Gut
        number of studies in this meta-analysis is relatively small. Second,   2004;53:456-65.
        there are differences in the time interval between appendectomy   [8]   Higgins JP, Green S. Cochrane Handbook for Systematic
        and the diagnosis of colorectal cancer, and there are differences   Reviews of Interventions  Version 5.1.0. London,
        in study design.  The lag time might have a role in tumor     United Kingdom: The Cochrane Collaboration; 2011.
        development  [17].  Third,  the  age  of patients  when they  were   [9]   Moher  D,  Liberati  A,  Tetzlaff  J,  Altman  DG,  PRISMA
        diagnosed with colorectal cancer was not available; therefore, it   Group. Preferred Reporting Items for Systematic Reviews
        is unclear  if patients  who undergo appendectomy  should have   and Meta-analyses: The PRISMA Statement. Ann Intern
        colorectal  cancer  screening earlier  than general  populations.   Med 2009;151:264-9, W264.
        There were no studies on the association of mucinous neoplasm   [10]  Stang  A. Critical  Evaluation  of the Newcastle-Ottawa
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        5. Conclusions                                          [11]  Duval S, Tweedie R. Trim and Fill: A Simple Funnel-plot-
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        appendectomy  the development  of proximal  colon cancer  but   [12]  Duval S,  Tweedie  R. A  Nonparametric  “Trim and Fill”
        not distal colon cancer. This study suggests that clinicians should   Method  of  Accounting  for  Publication  Bias  in  Meta-
        consider the possibility of colorectal cancer in patients with prior   analysis. J Am Stat Assoc 2000;95:89-98.
        appendectomy who develop new and persistent constitutional or
        gastrointestinal symptoms regardless of age.            [13]  Egger  M,  Smith  GD,  Schneider  M,  Minder  C.  Bias  in
                                                                      Meta-analysis Detected by a Simple, Graphical Test. BMJ
        Acknowledgments                                               1997;315:629-34.
                                                                [14]  Higgins JP, Thompson SG. Quantifying Heterogeneity in a
          None.
                                                                      Meta-analysis. Stat Med 2002;21:1539-58.
        Funding                                                 [15]  Higgins  JP,  Thomas  J,  Chandler  J,  Cumpston  M,  Li  T,
                                                                      Page M, et al. Cochrane Handbook for Systematic Reviews
          None.                                                       of Interventions. Hoboken: John Wiley and Sons; 2019.
        Conflicts of Interest                                   [16]  Thompson  SG,  Sharp  SJ.  Explaining  Heterogeneity  in
                                                                      Meta-analysis:  A  Comparison of Methods. Stat Med
          The authors declare they have no competing interests.       1999;18:2693-708.
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                                          DOI: http://dx.doi.org/10.18053/jctres.09.202305.23-00090
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