OBJECTIVES: Patients with inflammatory bowel disease (IBD) have an increased risk for colorectal cancer (CRC). Previous studies on early/missed CRCs after colonoscopy excluded IBD patients. The aim of this study was to compare the rate of early/missed CRCs after colonoscopy among IBD and non-IBD patients, and identify factors associated with early/missed CRCs. METHODS: All patients in the Surveillance, Epidemiology and End-Results Medicare-linked database who were 67 years or older at colonoscopy during 1998-2005 and those who were subsequently diagnosed with CRC within 36 months were identified. CRCs diagnosed within 6 months of colonoscopy were categorized as detected CRCs; CRCs diagnosed 6-36 months after colonoscopy were categorized as early/missed CRCs. The rate of early/missed CRCs was calculated as number of early/missed CRCs divided by number of detected and early/missed CRCs. The χ(2) test and multivariate logistic regression were used in statistical analysis. RESULTS: Of 55,008 CRC patients (304 Crohn's disease; 544 ulcerative colitis (UC)), the rate of early/missed CRCs was 5.8% for non-IBD patients, 15.1% for Crohn's, and 15.8% for UC (P<0.001). Compared with older non-IBD patients, early/missed CRCs among older IBD patients were less likely right-sided (both P<0.05). In multivariate logistic regression, the risk of early/missed CRCs was three times as high for IBD patients (Crohn's odds ratio (OR), 3.07; 95% confidence interval (CI) 2.23-4.21; UC OR, 3.05; 95% CI, 2.44-3.81). Sensitivity analyses confirmed the robustness of this finding. CONCLUSIONS: Older IBD patients had a higher rate of early/missed CRCs after colonoscopy. Our finding supports intensive surveillance colonoscopy for older IBD patients as recommended by guidelines.
OBJECTIVES:Patients with inflammatory bowel disease (IBD) have an increased risk for colorectal cancer (CRC). Previous studies on early/missed CRCs after colonoscopy excluded IBD patients. The aim of this study was to compare the rate of early/missed CRCs after colonoscopy among IBD and non-IBD patients, and identify factors associated with early/missed CRCs. METHODS: All patients in the Surveillance, Epidemiology and End-Results Medicare-linked database who were 67 years or older at colonoscopy during 1998-2005 and those who were subsequently diagnosed with CRC within 36 months were identified. CRCs diagnosed within 6 months of colonoscopy were categorized as detected CRCs; CRCs diagnosed 6-36 months after colonoscopy were categorized as early/missed CRCs. The rate of early/missed CRCs was calculated as number of early/missed CRCs divided by number of detected and early/missed CRCs. The χ(2) test and multivariate logistic regression were used in statistical analysis. RESULTS: Of 55,008 CRC patients (304 Crohn's disease; 544 ulcerative colitis (UC)), the rate of early/missed CRCs was 5.8% for non-IBD patients, 15.1% for Crohn's, and 15.8% for UC (P<0.001). Compared with older non-IBD patients, early/missed CRCs among older IBD patients were less likely right-sided (both P<0.05). In multivariate logistic regression, the risk of early/missed CRCs was three times as high for IBD patients (Crohn's odds ratio (OR), 3.07; 95% confidence interval (CI) 2.23-4.21; UC OR, 3.05; 95% CI, 2.44-3.81). Sensitivity analyses confirmed the robustness of this finding. CONCLUSIONS: Older IBD patients had a higher rate of early/missed CRCs after colonoscopy. Our finding supports intensive surveillance colonoscopy for older IBD patients as recommended by guidelines.
Authors: Swathi Eluri; Alyssa M Parian; Berkeley N Limketkai; Christina Y Ha; Steven R Brant; Sharon Dudley-Brown; Jonathan E Efron; Sandy G Fang; Susan L Gearhart; Michael R Marohn; Stephen J Meltzer; Safar Bashar; Brindusa Truta; Elizabeth A Montgomery; Mark G Lazarev Journal: Dig Dis Sci Date: 2017-06-19 Impact factor: 3.199
Authors: Stefan Harmsen; Stephan Rogalla; Ruimin Huang; Massimiliano Spaliviero; Volker Neuschmelting; Yoku Hayakawa; Yoomi Lee; Yagnesh Tailor; Ricardo Toledo-Crow; Jeon Woong Kang; Jason M Samii; Hazem Karabeber; Ryan M Davis; Julie R White; Matt van de Rijn; Sanjiv S Gambhir; Christopher H Contag; Timothy C Wang; Moritz F Kircher Journal: ACS Nano Date: 2019-02-04 Impact factor: 15.881
Authors: Millie D Long; Susan Hutfless; Michael D Kappelman; Hamed Khalili; Gilaad G Kaplan; Charles N Bernstein; Jean Frederic Colombel; Corinne Gower-Rousseau; Lisa Herrinton; Fernando Velayos; Edward V Loftus; Geoffrey C Nguyen; Ashwin N Ananthakrishnan; Amnon Sonnenberg; Andrew Chan; Robert S Sandler; Ashish Atreja; Samir A Shah; Kenneth J Rothman; Neal S Leleiko; Renee Bright; Paolo Boffetta; Kelly D Myers; Bruce E Sands Journal: Inflamm Bowel Dis Date: 2014-02 Impact factor: 5.325