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Inflammatory bowel disease (IBD) is associated with an increased risk of colon-associated colorectal cancer (CRC), and although IBD accounts for a relatively small percentage of the total burden of CRC, it accounts for a relatively high
share of CRC-related deaths.
IBD-associated CRC (IBD-CRC) has different tumor and patient-related factors
than sporadic CRC.
Although large population data are scarce, there is some evidence that IBD-CRC cases tend to be younger, tend to be more common in the right colon, and are associated with a poorer prognosis, and this study investigates the epidemiology of IBD-CRC and its outcomes
.
This study analysed using population data from the UK National Health Service held in the CRC database to include all CRCs diagnosed with IBD (Crohn's disease, ulcerative colitis, IBD unclassified, and IBD with cholangitis) between 2005 and 2018
.
Use descriptive analysis and logistic regression models to compare the features of two groups and their results
for up to 2 years.
The results of the study showed that 390614 cases were included with a diagnosis of CRC, of which 5141 (1.
3%) were also previously diagnosed with IBD
。 IBD-CRC cases were younger (median age [interquartile] 66 [54-76] vs 72 [63-79] years [P<0.
01]), more likely to have an urgent diagnosis of CRC (25.
1% vs 16.
7% [P<0.
01]), and more likely to have a right-sided colon tumor (37.
4% vs 31.
5% [P<0.
01]).
。 Total colectomy was performed in 36.
3% of patients with IBD (15.
4% had Crohn's disease, 44.
1% had ulcerative colitis, 44.
5% had unclassified IBD, and 67.
7% had IBD with cholangitis).
Simoneistic (3.
2% vs 1.
6% P<0.
01) and metachronous tumors (1.
7% vs 0.
9% P<0.
01) occur twice as frequently in patients with IBD as in patients without IBD
.
This study found that IBD-associated CRC occurred in younger patients and had worse
outcomes than sporadic CRC.
Therefore, there is an urgent need to find the reasons for these differences in order to assist
in screening, monitoring, and treatment strategies for CRC and its precursor diseases in this high-risk population.
Original source:
Birch, Rebecca J.
et al.
Inflammatory Bowel Disease-Associated Colorectal Cancer Epidemiology and Outcomes: An English Population-Based Study.
American Journal of Gastroenterology.
2022.