Risk factors for colorectal neoplasia in inflammatory bowel disease: A nested case-control study from Copenhagen County, Denmark and Olmsted County, Minnesota

Tine Jess, Edward V. Loftus, Fernando S. Velayos, Karen V. Winther, William J. Tremaine, Alan R. Zinsmeister, W. Scott Harmsen, Ebbe Langholz, Vibeke Binder, Pia Munkholm, William J. Sandborn

Research output: Contribution to journalArticle

107 Scopus citations

Abstract

OBJECTIVES: Population-based data on risk factors and protective factors for colorectal dysplasia and cancer in patients with inflammatory bowel disease (IBD) are sparse. We conducted a nested case-control study of such factors in two well-described IBD cohorts from Copenhagen County, Denmark and Olmsted County, Minnesota. METHODS: Forty-three neoplasia cases were matched on six criteria to 1-3 controls (N = 102). Medical records were scrutinized for demographic and clinical data. For each variable, the odds of neoplasia were estimated using conditional logistic regression. RESULTS: Primary sclerosing cholangitis (PSC) (odds ratio [OR] 6.9, 95% confidence interval [CI] 1.2-40), percentage of disease course with clinically active disease (OR [per 5% increase] 1.2, 95% CI 0.996-1.4), and ≥1 yr of continuous symptoms (OR 3.2, 95% CI 1.2-8.6) were associated with neoplasia, whereas a borderline association with median number of small-bowel x-rays (OR 1.3, 95% CI 0.96-1.6) was observed. We did not observe a protective effect of frequency of physician visits (OR 1.4, 95% CI 0.96-2.0), number of colonoscopies (OR 1.4, 95% CI 1.0-2.1), cumulative dose of sulfasalazine (OR [per 1,000 g] 1.1, 95% CI 1.0-1.3) and mesalamine (OR [per 1,000 g] 1.3, 95% CI 0.9-1.9), or partial intestinal resections (OR 1.5, 95% CI 0.3-7.1). CONCLUSIONS: Subgroups of IBD patients - those with PSC, severe long-standing disease, and exposure to x-ray - were at greater risk of colorectal neoplasia. The protective effect of close follow-up, colonoscopy, and treatment with 5-aminosalicylates was questionable.

Original languageEnglish (US)
Pages (from-to)829-836
Number of pages8
JournalAmerican Journal of Gastroenterology
Volume102
Issue number4
DOIs
StatePublished - Apr 1 2007

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Jess, T., Loftus, E. V., Velayos, F. S., Winther, K. V., Tremaine, W. J., Zinsmeister, A. R., Scott Harmsen, W., Langholz, E., Binder, V., Munkholm, P., & Sandborn, W. J. (2007). Risk factors for colorectal neoplasia in inflammatory bowel disease: A nested case-control study from Copenhagen County, Denmark and Olmsted County, Minnesota. American Journal of Gastroenterology, 102(4), 829-836. https://doi.org/10.1111/j.1572-0241.2007.01070.x