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Chronic constipation associated with colorectal cancer, benign neoplasms
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LAS VEGAS — Patients with chronic constipation are more likely to develop benign neoplasms and colorectal cancer than those without constipation, according to data presented at the 2012 American College of Gastroenterology Annual Scientific Meeting.
Researchers evaluated data from 28,854 adult patients with chronic constipation (CC), defined as two constipation diagnoses within 60 to 365 days of one another, along with 86,562 matched controls without CC. Patients were observed for a mean of 3.99 years from initial constipation diagnosis, and 1-year prevalence rates of colorectal cancer (CRC) and benign neoplasm were calculated.
Prevalence rates at 1 year were higher among patients with CC for both CRC (2.7% vs. 1.7%) and benign neoplasm (24.8% vs. 11.9%), with incidence of 5.2 compared with 2.9 per 1,000 patient-years for CRC, and 71.9 vs. 26.6 per 1,000 patient-years for benign neoplasm.
Investigators calculated unadjusted IRRs of 1.78 (1.60-1.99) for CRC and 2.70 (2.61-2.79) for benign neoplasms among patients with CC. After adjusting for potential confounders including age, gender, comorbidities, family history of malignancies and the index year (the year of the patient’s first constipation diagnosis), IRRs were 1.59 (1.43-1.78) for CRC and 2.60 (2.51-2.70) for neoplasm. After adjusting for the number of colonoscopies performed, researchers calculated IRRs of 1.20 (1.07-1.35) for CRC and 2.06 (1.98-2.15) for neoplasm (95% CI for all).
“This study demonstrates an association, not causation, between chronic constipation and both colorectal cancer and benign neoplasms,” researcher Nicholas Talley, MD, PhD, University of Newcastle, Australia, said in a press release. “Although chronic constipation is considered a relatively benign disease, practitioners should be aware of this potential association to monitor and treat accordingly.
“Longitudinal prospective studies to understand the causal relationship between chronic constipation and CRC would advance our understanding of prevention and management of these disorders.”
For more information:
Mody R. P866: Risk of Developing Colorectal Cancer and Benign Neoplasm in Patients with Chronic Constipation. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.
Disclosure: Industry support was provided by Takeda Pharmaceuticals International. Researchers Reema Mody, Wen Zhou, Karen Lasch and Katherine Brewer are employees of Takeda Pharmaceuticals International. Researchers Annie Guérin, Beverly Fok, Zhou Zhou and Erik Wu are employees of Analysis Group, Inc., which has received consulting fees from Takeda Pharmaceuticals International. Talley has received research support from Takeda Pharmaceuticals International.