N Jewel Samadder1,2, John F Valentine3, Stephen Guthery4, Harminder Singh5, Charles N Bernstein5, Yuan Wan6,7, Jathine Wong6,7, Kenneth Boucher6,8, Lisa Pappas6, Kerry Rowe9, Mary Bronner10, Cornelia M Ulrich6,11, Randall W Burt6,3,12, Karen Curtin6,13,7, Ken R Smith6,11,14,7. 1. Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA. Jewel.samadder@hsc.utah.edu. 2. Department of Medicine (Gastroenterology), University of Utah, Salt Lake City, UT, USA. Jewel.samadder@hsc.utah.edu. 3. Department of Medicine (Gastroenterology), University of Utah, Salt Lake City, UT, USA. 4. Department of Pediatrics (Gastroenterology), University of Utah, Salt Lake City, UT, USA. 5. Department of Internal Medicine (Gastroenterology), University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada. 6. Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA. 7. Department of Pedigree and Population Resource, University of Utah, Salt Lake City, UT, USA. 8. Department of Medicine (Epidemiology), University of Utah, Salt Lake City, UT, USA. 9. Department of Bioinformatics, Intermountain Healthcare, Salt Lake City, UT, USA. 10. Department of Pathology, University of Utah, Salt Lake City, UT, USA. 11. Department of Population Sciences, University of Utah, Salt Lake City, UT, USA. 12. Department of Oncological Sciences, University of Utah, Salt Lake City, UT, USA. 13. Department of Medicine (Genetic Epidemiology), University of Utah, Salt Lake City, UT, USA. 14. Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA.
Abstract
BACKGROUND AND AIMS: The molecular, endoscopic, and histological features of IBD-associated CRC differ from sporadic CRC. The objective of this study was to describe the prevalence, clinical features, and prognosis of IBD-associated CRC compared to patients with sporadic CRC in a US statewide population-based cohort. METHODS: All newly diagnosed cases of CRC between 1996 and 2011 were obtained from Utah Cancer Registry. IBD was identified using a previously validated algorithm, from statewide databases of Intermountain Healthcare, University of Utah Health Sciences, and the Utah Population Database. Logistic regression was performed to identify risk factors associated with IBD-associated cancer and Cox regression for differences in survival. RESULTS: Among 12,578 patients diagnosed with CRC, 101 (0.8%) had a prior history of IBD (61 ulcerative colitis and 40 Crohn's disease). The mean age at CRC diagnosis was greater for patients without IBD than those with IBD (67.1 vs 52.8 years, P < 0.001). Individuals with IBD-associated CRC were more likely to be men (odds ratio [OR] 1.90, 95% CI 1.23-2.92), aged less than 65 years (OR 6.77, 95% CI 4.06-11.27), and have CRC located in the proximal colon (OR 2.79, 95% CI 1.85-4.20) than those with sporadic CRC. Nearly 20% of the IBD-associated CRCs had evidence of primary sclerosing cholangitis. After adjustment for age, gender, and stage at diagnosis, the excess hazard of death after CRC diagnosis was 1.7 times higher in IBD than in non-IBD patients (95% CI 1.27-2.33). CONCLUSIONS: The features of patients with CRC and IBD differ significantly from those without IBD and may be associated with increased mortality.
BACKGROUND AND AIMS: The molecular, endoscopic, and histological features of IBD-associated CRC differ from sporadic CRC. The objective of this study was to describe the prevalence, clinical features, and prognosis of IBD-associated CRC compared to patients with sporadic CRC in a US statewide population-based cohort. METHODS: All newly diagnosed cases of CRC between 1996 and 2011 were obtained from Utah Cancer Registry. IBD was identified using a previously validated algorithm, from statewide databases of Intermountain Healthcare, University of Utah Health Sciences, and the Utah Population Database. Logistic regression was performed to identify risk factors associated with IBD-associated cancer and Cox regression for differences in survival. RESULTS: Among 12,578 patients diagnosed with CRC, 101 (0.8%) had a prior history of IBD (61 ulcerative colitis and 40 Crohn's disease). The mean age at CRC diagnosis was greater for patients without IBD than those with IBD (67.1 vs 52.8 years, P < 0.001). Individuals with IBD-associated CRC were more likely to be men (odds ratio [OR] 1.90, 95% CI 1.23-2.92), aged less than 65 years (OR 6.77, 95% CI 4.06-11.27), and have CRC located in the proximal colon (OR 2.79, 95% CI 1.85-4.20) than those with sporadic CRC. Nearly 20% of the IBD-associated CRCs had evidence of primary sclerosing cholangitis. After adjustment for age, gender, and stage at diagnosis, the excess hazard of death after CRC diagnosis was 1.7 times higher in IBD than in non-IBD patients (95% CI 1.27-2.33). CONCLUSIONS: The features of patients with CRC and IBD differ significantly from those without IBD and may be associated with increased mortality.
Authors: Charles N Bernstein; Andre Wajda; Lawrence W Svenson; Adrian MacKenzie; Mieke Koehoorn; Maureen Jackson; Richard Fedorak; David Israel; James F Blanchard Journal: Am J Gastroenterol Date: 2006-07 Impact factor: 10.864
Authors: Susan L Gearhart; Hari Nathan; Timothy M Pawlik; Elizabeth Wick; Jonathan Efron; Andrew D Shore Journal: Dis Colon Rectum Date: 2012-03 Impact factor: 4.585
Authors: Eric I Benchimol; Astrid Guttmann; David R Mack; Geoffrey C Nguyen; John K Marshall; James C Gregor; Jenna Wong; Alan J Forster; Douglas G Manuel Journal: J Clin Epidemiol Date: 2014-04-26 Impact factor: 6.437
Authors: Thierry Delaunoit; Paul J Limburg; Richard M Goldberg; James F Lymp; Edward V Loftus Journal: Clin Gastroenterol Hepatol Date: 2006-03 Impact factor: 11.382
Authors: Sverre Söderlund; Fredrik Granath; Olle Broström; Per Karlén; Robert Löfberg; Anders Ekbom; Johan Askling Journal: Gastroenterology Date: 2010-02-16 Impact factor: 22.682
Authors: Mitchell Ramsey; Somashekar G Krishna; Peter P Stanich; Syed Husain; Edward J Levine; Darwin Conwell; Alice Hinton; Cheng Zhang Journal: Clin Transl Gastroenterol Date: 2017-11-30 Impact factor: 4.488
Authors: Annie E Wolfe; Jacob E Moskowitz; Craig L Franklin; Timothy L Wiemken; Aaron C Ericsson Journal: PLoS One Date: 2020-07-24 Impact factor: 3.240