Incidence rate of CRC in patients with IBD elevated, stable over time
The risk for colorectal adenocarcinoma among patients with IBD remained elevated compared with the general population, but stable between 1998 and 2010, according to recent results.
The study included data from the Kaiser Permanente of Northern California database of patients with IBD, along with general membership data from the Kaiser Permanente Medical Care Program, from 1998 through June 2010. Researchers determined incidence and mortality rates over time for colorectal adenocarcinoma (CRC) among adults with intact colons.
The cohort included 5,053 patients with Crohn’s disease (CD), 9,822 with ulcerative colitis (UC) and 4,459,950 without IBD representing the general population. CRC was present in 29 CD patients, 53 UC patients and 13,938 patients in the general population. Incidence rates were 75, 76 and 47.1 per 100,000 person-years for CD, UC and the general population, respectively. Patients with IBD were at a 60% greater risk for CRC than the general population (95% CI, 1.2-2.0 for CD; 95% CI, 1.3-2.0 for UC).
Incidence of CRC was 21% higher between 2007 and 2010 than between 1998 and 2001 for the general population (P<.0001 for trend), but rate variations during time among IBD patients were not found statistically significant (P=.98 for CD and P=.40 for UC).
Standardized mortality rates from CRC between 1998 and 2008 were greater for both CD and UC patients compared with the general population (SMR=2.3; 95% CI, 1.6-3.0 for CD and SMR=2.0; 95% CI, 1.3-2.7 for UC). All-cause mortality and death from causes other than CRC also were higher for patients with IBD (SMR=1.7; 95% CI, 1.6-1.8 for CD and SMR=1.5; 95% CI, 1.4-1.6 for UC).
Lisa J. Herrinton
“Patients with ulcerative colitis and Crohn’s disease were at a modestly increased risk for colorectal cancer,” Lisa J. Herrinton, PhD, research scientist at Kaiser Permanente, told Healio.com. “Their risk was 60% higher than [that of] the general population. This level of risk is lower than reported in older studies, and might reflect improved control of inflammation or early detection of pre-cancerous lesions.”
Disclosure: See the study for a full list of relevant disclosures.