TY - JOUR
T1 - Colorectal Cancer in Inflammatory Bowel Diseases
T2 - A Population-Based Study in Utah
AU - Jewel Samadder, N.
AU - Valentine, John F.
AU - Guthery, Stephen
AU - Singh, Harminder
AU - Bernstein, Charles N.
AU - Wan, Yuan
AU - Wong, Jathine
AU - Boucher, Kenneth
AU - Pappas, Lisa
AU - Rowe, Kerry
AU - Bronner, Mary
AU - Ulrich, Cornelia M.
AU - Burt, Randall W.
AU - Curtin, Karen
AU - Smith, Ken R.
N1 - Publisher Copyright:
© 2017, Springer Science+Business Media New York.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Background and Aims: The molecular, endoscopic, and histological features of IBD-associated CRC differ from sporadic CRC. The objective of this study was to describe the prevalence, clinical features, and prognosis of IBD-associated CRC compared to patients with sporadic CRC in a US statewide population-based cohort. Methods: All newly diagnosed cases of CRC between 1996 and 2011 were obtained from Utah Cancer Registry. IBD was identified using a previously validated algorithm, from statewide databases of Intermountain Healthcare, University of Utah Health Sciences, and the Utah Population Database. Logistic regression was performed to identify risk factors associated with IBD-associated cancer and Cox regression for differences in survival. Results: Among 12,578 patients diagnosed with CRC, 101 (0.8%) had a prior history of IBD (61 ulcerative colitis and 40 Crohn’s disease). The mean age at CRC diagnosis was greater for patients without IBD than those with IBD (67.1 vs 52.8 years, P < 0.001). Individuals with IBD-associated CRC were more likely to be men (odds ratio [OR] 1.90, 95% CI 1.23–2.92), aged less than 65 years (OR 6.77, 95% CI 4.06–11.27), and have CRC located in the proximal colon (OR 2.79, 95% CI 1.85–4.20) than those with sporadic CRC. Nearly 20% of the IBD-associated CRCs had evidence of primary sclerosing cholangitis. After adjustment for age, gender, and stage at diagnosis, the excess hazard of death after CRC diagnosis was 1.7 times higher in IBD than in non-IBD patients (95% CI 1.27–2.33). Conclusions: The features of patients with CRC and IBD differ significantly from those without IBD and may be associated with increased mortality.
AB - Background and Aims: The molecular, endoscopic, and histological features of IBD-associated CRC differ from sporadic CRC. The objective of this study was to describe the prevalence, clinical features, and prognosis of IBD-associated CRC compared to patients with sporadic CRC in a US statewide population-based cohort. Methods: All newly diagnosed cases of CRC between 1996 and 2011 were obtained from Utah Cancer Registry. IBD was identified using a previously validated algorithm, from statewide databases of Intermountain Healthcare, University of Utah Health Sciences, and the Utah Population Database. Logistic regression was performed to identify risk factors associated with IBD-associated cancer and Cox regression for differences in survival. Results: Among 12,578 patients diagnosed with CRC, 101 (0.8%) had a prior history of IBD (61 ulcerative colitis and 40 Crohn’s disease). The mean age at CRC diagnosis was greater for patients without IBD than those with IBD (67.1 vs 52.8 years, P < 0.001). Individuals with IBD-associated CRC were more likely to be men (odds ratio [OR] 1.90, 95% CI 1.23–2.92), aged less than 65 years (OR 6.77, 95% CI 4.06–11.27), and have CRC located in the proximal colon (OR 2.79, 95% CI 1.85–4.20) than those with sporadic CRC. Nearly 20% of the IBD-associated CRCs had evidence of primary sclerosing cholangitis. After adjustment for age, gender, and stage at diagnosis, the excess hazard of death after CRC diagnosis was 1.7 times higher in IBD than in non-IBD patients (95% CI 1.27–2.33). Conclusions: The features of patients with CRC and IBD differ significantly from those without IBD and may be associated with increased mortality.
KW - Colorectal cancer
KW - Crohn’s disease
KW - Inflammatory bowel disease
KW - Ulcerative colitis
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U2 - 10.1007/s10620-016-4435-4
DO - 10.1007/s10620-016-4435-4
M3 - Article
C2 - 28050782
AN - SCOPUS:85008164733
SN - 0163-2116
VL - 62
SP - 2126
EP - 2132
JO - Digestive diseases and sciences
JF - Digestive diseases and sciences
IS - 8
ER -