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Chronic constipation linked to increased risk for colorectal cancer
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Patients with chronic constipation displayed a significantly greater risk for developing colorectal cancer and benign colorectal neoplasms, a risk that increased with constipation severity, according to study data.
Using data derived from the Ingenix Employer Solutions claims database between 1999 and 2011, researchers retrospectively matched patients with chronic constipation (CC; n=28,854) and CC-free controls (n=86,562) based on age, gender and region of residence. CC severity was defined as “mild,” “severe” or “very severe” based on indicators measured during the observation period, including CC-related office visits or medical procedures, GI specialist visits and laxative prescriptions.
The risk for colorectal cancer (CRC) and benign colorectal neoplasm (BCN) was compared between severity-stratified CC groups and controls, with both diagnoses defined from medical claims as at least one diagnosis during the 1-year post-index period. CC patients had a greater prevalence of CRC compared with controls (2.7% vs. 1.7%; P<.001) and BCN (24.8% vs. 11.9%; P<.001).
When adjusted for age, sex, comorbidities and family cancer history, CRC incidence (IRR=1.59; 95% CI, 1.43-1.78) and BCN (IRR=2.6; 95% CI, 2.51-2.7) also was significantly greater for CC patients during observations that averaged 4 years. Patients with “severe” and “very severe” CC had significantly greater incremental risk for CRC (adjusted IRR=1.4; 95% CI, 1.18-1.66; aIRR=2.26; 95% CI, 1.94-2.64, respectively) and BCN (aIRR=2.03; 95% CI, 1.93-2.13; aIRR=3.3; 95% CI, 3.16-3.45, respectively) compared with controls.
Sex subset data indicated higher prevalence and incidence of CRC and BCN in men (aIRR=1.49; 95% CI, 1.26-1.76; aIRR=2.48; 95% CI, 2.33-2.63, respectively) vs. women (aIRR=1.67; 95% CI, 1.45-1.93; aIRR=2.68; 95% CI, 2.56-2.81, respectively).
The researchers said patients with more severe CC had a significantly greater risk for CRC and BCN compared with CC-free patients, and that risk increased with the level of severity.
“Although CC is considered as a relatively benign disease, practitioners should be aware of this potential association in order to monitor and treat accordingly,” the investigators concluded.
Disclosure: See the study for a full list of relevant financial disclosures.
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