Risk of colorectal cancer and small bowel adenocarcinoma in Crohn's disease: A population-based study from western Hungary 1977-2008

Peter Laszlo Lakatos, Gyula David, Tunde Pandur, Zsuzsanna Erdelyi, Gabor Mester, Mihaly Balogh, Istvan Szipocs, Csaba Molnar, Erzsebet Komaromi, Lajos S. Kiss, Laszlo Lakatos

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Abstract

Background and aims: Limited data are available on the incidence and predictors of colorectal (CRC) and small bowel adenocarcinoma (SBA) in patients with Crohn's disease (CD) from population-based cohorts. Since data are completely missing from Eastern Europe, our aim was to analyze the incidence and risk factors of CD associated CRC and SBA in the population-based, Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008. Methods: The data of 506 incident CD patients were analyzed (age-at-diagnosis: 31.5, SD: 13.8. years). Both hospital and outpatient records were collected and comprehensively reviewed. Results: CRC was diagnosed in five patients (5/5758 person-year-duration) during follow-up, while no patients developed SBA in this cohort. Standardized incidence ratio (SIR) of CRC was not increased overall with five cases observed vs. 5.02 expected (SIR: 0.99, 95% CI: 0.41-2.39); however, there was a tendency for increased incidence in males (five cases observed vs. 2.56 expected; SIR: 1.95, 95% CI: 0.81-4.70). Age at onset of CD (p< 0.001), male gender (p= 0.022) and stenosing disease behavior at diagnosis (p< 0.001) but not disease location were identified as risk factors for developing CRC in univariate analysis and Kaplan-Meier analysis. The cumulative risk for developing CRC after a disease duration of 20. years was 1.1% (95% CI: 0.6-1.7%). Conclusions: The incidence of CRC and SBA was not increased in this population-based CD cohort. Age at onset of CD, male gender and stenosing disease behavior at diagnosis were identified as risk factors of CRC.

Original languageEnglish
Pages (from-to)122-128
Number of pages7
JournalJournal of Crohn's and Colitis
Volume5
Issue number2
DOIs
Publication statusPublished - Apr 1 2011

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Keywords

  • CD
  • Colorectal cancer
  • Incidence
  • Risk factors
  • Small bowel adenocarcinoma

ASJC Scopus subject areas

  • Gastroenterology

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