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Risk for colorectal cancer decreased among patients with IBD
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Most patients with ulcerative colitis or Crohn’s disease were not found to be at increased risk for developing colorectal cancer in a recent study.
Researchers evaluated data from 47,374 Danish patients with IBD from an initial national cohort of 7.9 million people. Incidence rates of colorectal cancer (CRC) were collected, and calculations were made for RRs for CRC development from 1 year after diagnosis with either ulcerative colitis (UC) (n=32,911) or Crohn’s disease (CD) (n=14,463).
During the study, CRC was developed by 268 patients with UC, 70 with CD and 105,513 without IBD. Incidence rates per 100,000 person-years were 51.4 (95% CI, 46.4-61.3) for UC and 32.7 (95% CI, 27.9-47.1) for CD compared with 38.2 (95% CI, 38.0-38.5) among those without IBD.
Patients with UC had an overall RR of 1.07 (95% CI, 0.95-1.21) that varied according to time, with an RR of 1.34 (95% CI, 1.13-1.58) between 1979 and 1988 decreasing to 0.57 (95% CI, 0.41-0.80) between 1999 and 2008. Investigators observed that patients with UC diagnosed during childhood or adolescence (RR=43.8; 95% CI, 27.2-70.7 for patients aged 0 through 19 years), patients who experienced a longer disease duration (approximately 50% greater risk after 13 years) and those with primary sclerosing cholangitis (RR=9.13; 95% CI, 4.52-18.5) remained at increased risk for developing CRC.
Patients with CD had an overall RR of 0.85 (95% CI, 0.67-1.07) for CRC that did not change. Risk increased slightly among patients aged 20 to 39 years at diagnosis (RR=1.60; 95% CI, 0.95-2.71), but this was not considered significant, and patients aged 40 years or older at diagnosis were at decreased risk for CRC development (RR=0.75; 95% CI, 0.57-0.98).
“The present nationwide study covering 178 million person-years of follow-up evaluation of IBD patients and non-IBD individuals … showed an increased risk of CRC among patients diagnosed with UC in the 1980s,” the researchers wrote. “Since then, CRC risk in Danish UC patients has declined and no longer exceeds that of persons without IBD. The decreasing risk for CRC from 1979 to 2008 might result from improved therapies for patients with IBD.”
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