Patients with inflammatory bowel disease-associated colorectal cancer appeared to have worse survival than patients with sporadic CRC, mostly due to survival differences among younger patients, according to study results.
Jessica Bogach, MD, from the department of surgery at McMaster University in Canada, and colleagues wrote in Inflammatory Bowel Diseases that studies looking at survival outcomes for patients with IBD and CRC are inconsistent because of the role of chronic inflammation.
“There are differences in the rate of disease progression, the order of mutations, and the activation of cellular pathways that impact the development of CRC,” they wrote. “The inflammation in IBD can lead to dysplasia, which progresses to malignancy, which in IBD does not always follow the classic ‘adenoma-carcinoma sequence’ seen in sporadic CRC. This highlights the importance of studying the outcomes of IBD-associated CRC compared with sporadic CRC.”
Researchers identified adult patients with a diagnosis of CRC using the Ontario Cancer Registry and compared survival outcomes between patients with and without IBD. Of 67,137 patients diagnosed between 2007 and 2015, 783 (1.2%) also had IBD. These patients were younger at diagnosis than those without IBD (median range 55–59 vs. 70–74 years; P < .001).
Investigators found that 5-year survival was similar in both groups (IBD: 56.4%; 95% CI, 52.6%–59.9%; sporadic: 57%; 95% CI, 56.6%–57.4%). However, when they divided patients into age cohorts, they found that patients with IBD-related CRC younger than 50 years had worse 5-year survival (56.8%; 95% CI, 49.4%–63.5%) compared with patients with sporadic CRC in the same age group (71.4%; 95% CI, 70%–72.7%). Researchers found similar results in the age 50-64 years cohort.
Additionally, IBD was a predictor of death after adjusting for other variables (HR = 1.45; 95% CI, 1.29–1.63).
“Patients with IBD-associated CRC appear to have worse survival than in sporadic CRC, despite similar treatments, after adjustment for other measurable factors,” Bogach and colleagues wrote. “In subgroups based on age, this difference appears to be driven by young patients with IBD. These findings may direct future research on treatment for this high-risk population.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.