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Dig Dis Sci. 2017 Aug;62(8):2126-2132. doi: 10.1007/s10620-016-4435-4. Epub 2017 Jan 3.

Colorectal Cancer in Inflammatory Bowel Diseases: A Population-Based Study in Utah.

Author information

1
Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA. Jewel.samadder@hsc.utah.edu.
2
Department of Medicine (Gastroenterology), University of Utah, Salt Lake City, UT, USA. Jewel.samadder@hsc.utah.edu.
3
Department of Medicine (Gastroenterology), University of Utah, Salt Lake City, UT, USA.
4
Department of Pediatrics (Gastroenterology), University of Utah, Salt Lake City, UT, USA.
5
Department of Internal Medicine (Gastroenterology), University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada.
6
Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.
7
Department of Pedigree and Population Resource, University of Utah, Salt Lake City, UT, USA.
8
Department of Medicine (Epidemiology), University of Utah, Salt Lake City, UT, USA.
9
Department of Bioinformatics, Intermountain Healthcare, Salt Lake City, UT, USA.
10
Department of Pathology, University of Utah, Salt Lake City, UT, USA.
11
Department of Population Sciences, University of Utah, Salt Lake City, UT, USA.
12
Department of Oncological Sciences, University of Utah, Salt Lake City, UT, USA.
13
Department of Medicine (Genetic Epidemiology), University of Utah, Salt Lake City, UT, USA.
14
Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA.

Abstract

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.

KEYWORDS:

Colorectal cancer; Crohn’s disease; Inflammatory bowel disease; Ulcerative colitis

PMID:
28050782
DOI:
10.1007/s10620-016-4435-4
[Indexed for MEDLINE]

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