VIDEO: Primary sclerosing cholangitis increases risk for CRC, even among those without IBD
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Key takeaways:
- Patients with primary sclerosing cholangitis were at increased risk for colorectal cancer, regardless of whether they also had IBD.
- These patients also had a higher risk for other GI cancers.
PHILADELPHIA — Primary sclerosing cholangitis is an independent risk factor for colorectal cancer, with an “almost three-times higher” risk among patients without inflammatory bowel disease vs. the general population, a researcher reported.
“Our results showed that patients with PSC, regardless of history of IBD, were at increased risk of colorectal cancer,” Saqr Alsakarneh, MD, a third-year resident at University of Missouri-Kansas City School of Medicine who presented the research at the ACG Annual Scientific Meeting, told Healio. “More importantly, PSC patients without a history of IBD were also at increased risk — almost three-times higher than the general population.”
In a retrospective cohort study of nearly 15,000 patients with primary sclerosing cholangitis (PSC), 2,662 patients (mean age, 51.6 years; 47.2% women) with PSC but not IBD were at higher risk for developing CRC compared with those without a history of PSC or IBD (adjusted HR = 2.9; 95% CI, 1.6-6). This increased risk was evident among men (aHR = 4.17; 95% CI, 1.4-12.5) but not women (aHR = 2.1; 95% CI, 0.8-6.1).
Patients with PSC and IBD also were at increased risk for CRC (aHR = 6.5; 95% CI, 3.78-11.2), particularly those with ulcerative colitis (aHR = 6.3; 95% CI, 3.2-12.4), which was consistent among both men and women.
“This finding suggests that current screening guidelines should be revised and updated to ensure all PSC patients are monitored for colorectal cancer, with more close and frequent colorectal cancer screening colonoscopy regardless of whether they have IBD or not,” Alsakarneh said. “This is really critical for early detection and better outcomes in this high-risk group.”
Patients with PSC also had a significantly greater risk for other gastrointestinal malignancies, including hepatobiliary and pancreatic cancers and hepatocellular carcinoma (aHR = 10.5; 95% CI, 7.3-15).
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Alsakarneh S, et al. Primary sclerosing cholangitis in the absence of inflammatory bowel disease increases the risk of colorectal cancer: A propensity-matched cohort study. Presented at: ACG Annual Scientific Meeting: Oct. 25-30, 2024; Philadelphia (hybrid meeting).
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