Risk of Intestinal Cancer in Inflammatory Bowel Disease: A Population-Based Study From Olmsted County, Minnesota

Tine Jess, Edward Vincent Loftus, Jr, Fernando S. Velayos, W. Scott Harmsen, Alan R. Zinsmeister, Thomas Christopher Smyrk, Cathy D. Schleck, William J. Tremaine, L. Joseph Melton, Pia Munkholm, William J. Sandborn

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Abstract

Background & Aims: The risk for colorectal cancer in Crohn's disease and ulcerative colitis patients from the United States currently is unknown. We estimated the risk for small-bowel and colorectal cancer in a population-based cohort of 692 inflammatory bowel disease patients from Olmsted County, Minnesota, from 1940 to 2001. Methods: The Rochester Epidemiology Project was used to identify cohort patients with colorectal and small-bowel cancer. The cumulative probability of cancer and standardized incidence ratios (SIR) were estimated using expected rates from Surveillance, Epidemiology, and End Results, white patients from Iowa, from 1973 to 2000, and Olmsted County, from 1980 to 1999. Results: Colorectal cancer was observed in 6 ulcerative colitis patients vs 5.38 expected (SIR, 1.1; 95% confidence interval [CI], 0.4-2.4), but 4 of these occurred among those with extensive colitis or pancolitis (SIR, 2.4; 95% CI, 0.6-6.0). Six Crohn's disease patients (vs 3.2 expected) developed colorectal cancer (SIR, 1.9; 95% CI, 0.7-4.1). Three Crohn's disease patients developed small-bowel cancer vs 0.07 expected (SIR, 40.6; 95% CI, 8.4-118). Conclusions: The risk for colorectal cancer was not increased among ulcerative colitis patients overall, but appeared to be increased among those with extensive colitis. The colorectal cancer risk was increased slightly among Crohn's disease patients, who also had a 40-fold excess risk for small-bowel cancer.

Original languageEnglish (US)
Pages (from-to)1039-1046
Number of pages8
JournalGastroenterology
Volume130
Issue number4
DOIs
StatePublished - Apr 2006

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Intestinal Neoplasms
Inflammatory Bowel Diseases
Colorectal Neoplasms
Population
Crohn Disease
Ulcerative Colitis
Confidence Intervals
Incidence
Colitis
Epidemiology

ASJC Scopus subject areas

  • Gastroenterology

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Risk of Intestinal Cancer in Inflammatory Bowel Disease : A Population-Based Study From Olmsted County, Minnesota. / Jess, Tine; Loftus, Jr, Edward Vincent; Velayos, Fernando S.; Harmsen, W. Scott; Zinsmeister, Alan R.; Smyrk, Thomas Christopher; Schleck, Cathy D.; Tremaine, William J.; Melton, L. Joseph; Munkholm, Pia; Sandborn, William J.

In: Gastroenterology, Vol. 130, No. 4, 04.2006, p. 1039-1046.

Research output: Contribution to journalArticle

Jess, T, Loftus, Jr, EV, Velayos, FS, Harmsen, WS, Zinsmeister, AR, Smyrk, TC, Schleck, CD, Tremaine, WJ, Melton, LJ, Munkholm, P & Sandborn, WJ 2006, 'Risk of Intestinal Cancer in Inflammatory Bowel Disease: A Population-Based Study From Olmsted County, Minnesota', Gastroenterology, vol. 130, no. 4, pp. 1039-1046. https://doi.org/10.1053/j.gastro.2005.12.037
Jess, Tine ; Loftus, Jr, Edward Vincent ; Velayos, Fernando S. ; Harmsen, W. Scott ; Zinsmeister, Alan R. ; Smyrk, Thomas Christopher ; Schleck, Cathy D. ; Tremaine, William J. ; Melton, L. Joseph ; Munkholm, Pia ; Sandborn, William J. / Risk of Intestinal Cancer in Inflammatory Bowel Disease : A Population-Based Study From Olmsted County, Minnesota. In: Gastroenterology. 2006 ; Vol. 130, No. 4. pp. 1039-1046.
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abstract = "Background & Aims: The risk for colorectal cancer in Crohn's disease and ulcerative colitis patients from the United States currently is unknown. We estimated the risk for small-bowel and colorectal cancer in a population-based cohort of 692 inflammatory bowel disease patients from Olmsted County, Minnesota, from 1940 to 2001. Methods: The Rochester Epidemiology Project was used to identify cohort patients with colorectal and small-bowel cancer. The cumulative probability of cancer and standardized incidence ratios (SIR) were estimated using expected rates from Surveillance, Epidemiology, and End Results, white patients from Iowa, from 1973 to 2000, and Olmsted County, from 1980 to 1999. Results: Colorectal cancer was observed in 6 ulcerative colitis patients vs 5.38 expected (SIR, 1.1; 95{\%} confidence interval [CI], 0.4-2.4), but 4 of these occurred among those with extensive colitis or pancolitis (SIR, 2.4; 95{\%} CI, 0.6-6.0). Six Crohn's disease patients (vs 3.2 expected) developed colorectal cancer (SIR, 1.9; 95{\%} CI, 0.7-4.1). Three Crohn's disease patients developed small-bowel cancer vs 0.07 expected (SIR, 40.6; 95{\%} CI, 8.4-118). Conclusions: The risk for colorectal cancer was not increased among ulcerative colitis patients overall, but appeared to be increased among those with extensive colitis. The colorectal cancer risk was increased slightly among Crohn's disease patients, who also had a 40-fold excess risk for small-bowel cancer.",
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AU - Jess, Tine

AU - Loftus, Jr, Edward Vincent

AU - Velayos, Fernando S.

AU - Harmsen, W. Scott

AU - Zinsmeister, Alan R.

AU - Smyrk, Thomas Christopher

AU - Schleck, Cathy D.

AU - Tremaine, William J.

AU - Melton, L. Joseph

AU - Munkholm, Pia

AU - Sandborn, William J.

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