Scandinavian Population-Based Study of Crohn’s Disease in Colorectal Cancer
Posted: Wednesday, June 17, 2020
Patients with Crohn’s disease appear to be at an increased risk of colorectal cancer and death from colorectal cancer compared with individuals without the chronic inflammatory bowel disease, according to a Scandinavian study published in The Lancet Gastroenterology & Hepatology. Among patients with Crohn’s disease who are eligible for heightened colorectal cancer surveillance per current guidelines—those with follow-ups of 8 years or longer or who were diagnosed with primary sclerosing cholangitis—the researchers identified cohorts with a significantly increased risk of colorectal cancer: those diagnosed with Crohn’s disease before the age of 40 years, patients with colon inflammation, and those who have primary sclerosing cholangitis.
“Colorectal cancer surveillance should consider targeting high-risk groups of patients with Crohn’s disease,” stated Ola Olén, MD, PhD, of the Karolinska Institutet, Stockholm, and colleagues.
The population-based cohort study included 47,035 patients with incident Crohn’s disease between 1969 and 2017 from 2 countries: Denmark (n = 13,056) and Sweden (n = 33,979). For each patient with Crohn’s disease, the incidence of colorectal cancer was compared with up to 10 matched reference individuals from the general population (n = 463,187).
During the follow-up period, 296 colorectal cancer deaths occurred among individuals with Crohn’s disease compared with 1,968 in reference individuals (0.47 vs. 0.31 per 1,000 person-years, hazard ratio = 1.74). In the Crohn’s disease and reference cohorts, 499 and 4,084 cases of colorectal cancer were diagnosed, respectively (0.82 vs. 0.64 1,000 person-years, hazard ratio = 1.4). Although tumor stage at diagnosis did not differ significantly, patients with Crohn’s disease who were diagnosed with colorectal cancer were at an increased risk of mortality compared with reference individuals also diagnosed with colorectal cancer.
Disclosure: The authors’ disclosure information can be found at www.thelancet.com.