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AIM: To examine the association between circulating 25-hydroxyvitamin D [25(OH)D] levels and colorectal adenoma in a case-control study and a meta-analysis. METHODS: We conducted a matched case-control study(112 cases and 112 matched controls) and combined 15 studies, including our study, in a metaanalysis. The study-specific odds ratios(ORs) and 95% confidence intervals(CIs) were pooled using a randomeffects model. In total, 5454 colorectal adenomas and 6656 controls were included in the meta-analysis. RESULTS: In a meta-analysis including 14 previous studies and our study, we observed a significant inverse association between circulating 25(OH)D levels and colorectal adenoma(OR = 0.68; 95%CI: 0.54-0.82) when comparing the highest category with the lowest category. Stratification by adenoma location(proximal or distal adenoma) showed similar estimates. When we stratified by study region, the ORs(95%CIs) were 0.70(0.52-0.88) in the US and 0.66(0.34-0.97) in Asia. CONCLUSION: These data suggest an inverse association between circulating 25(OH) Dlevels and colorectal adenoma in both Western and Asian populations.