Clinical—Alimentary TractDecreasing Time-Trends of Colorectal Cancer in a Large Cohort of Patients With Inflammatory Bowel Disease
Section snippets
Setting
We performed a population-based cohort study including 3 Swedish cohorts of patients with UC or CD, with follow-up evaluation for vital status and cancer occurrence through national registers into which data have been recorded prospectively. The Swedish personal identification number system allowed for register linkages. The diagnosis of CRC was obtained through the Swedish National Cancer Register, which was started in 1958 and has been in use since 1960. This register contains information on
Overall Occurrence of, and Mortality From, CRC
In total, 7607 patients with IBD were followed up for a total of 198,227 person-years. During this time, 196 cases of CRC were registered in 188 individuals, corresponding to an unadjusted overall incidence of 95 (95% CI, 82–109) cases per 100,000 person-years. There were 135 first primary cases of CRC among patients with UC (pancolitis, 66; left-sided, 31; proctitis, 35; and extent unknown, 3) and 53 among patients with CD (colonic CD, 16; other CD, 37). Within the cohort and compared with UC
Discussion
In this study we found that in a large population-based cohort of patients with IBD, and after taking age, sex, time with IBD, and type of IBD into account, the risk of being diagnosed with CRC did not display any statistically significant trend from the 1960s through 2004, at least not within the IBD cohort. By contrast, the risk of death from CRC declined markedly during the same time period, both as measured within the IBD cohort and as compared with the general population. Indeed, during
References (27)
- et al.
Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis
Gastroenterology
(2004) - et al.
Family history as a risk factor for colorectal cancer in inflammatory bowel disease
Gastroenterology
(2001) - et al.
Thirty-year analysis of a colonoscopic surveillance program for neoplasia in ulcerative colitis
Gastroenterology
(2006) - et al.
Colonoscopic surveillance in long-standing total ulcerative colitis—a 15-year follow-up study
Gastroenterology
(1990) - et al.
The epidemiology of inflammatory bowel disease: a large, population-based study in Sweden
Gastroenterology
(1991) - et al.
Survival and cause-specific mortality in inflammatory bowel disease: a population-based cohort study
Gastroenterology
(1996) - et al.
Risk of intestinal cancer in inflammatory bowel disease: a population-based study from Olmsted county, Minnesota
Gastroenterology
(2006) - et al.
Increased risk of large-bowel cancer in Crohn's disease with colonic involvement
Lancet
(1990) - et al.
Colorectal cancer in patients with ulcerative colitisA population study in central Israel
Gastroenterology
(1988) - et al.
Long-term risk of cancer in ulcerative colitis: a population-based cohort study from Copenhagen County
Clin Gastroenterol Hepatol
(2004)
Risk factors for colorectal cancer in patients with ulcerative colitis: a case-control study
Gastroenterology
Improved survival in cancer of the colon and rectum in Sweden
Eur J Surg Oncol
The risk of colorectal cancer in ulcerative colitis: a meta-analysis
Gut
Cited by (0)
This article has an accompanying continuing medical education activity on page 1818. Learning Objective: Upon completion of this CME exam successful learners will be able to discuss different risk estimates for CRC incidence and mortality in IBD.
Conflict of interest The authors disclose no conflicts.
Funding This study was supported by the Swedish Medical Association and the Swedish Cancer Society.