Increased risk of rectal cancer after colectomy in IBD

The risk of rectal cancer was 8 times higher in patients with a diverted rectum after subtotal colectomy, as compared with inflammatory bowel disease (IBD) patients without a history of subtotal colectomy. This result implies that this subgroup of patients needs a specific strategy monitoring rectal cancer.

The cumulative risk of subtotal colectomy with ileostomy and diverted rectum is ~7.5% after 5 years. The current, nationwide Danish, population-based cohort study compared the risk of rectal cancer in IBD patients with a diverted rectum following subtotal colectomy with IBD patients without surgery [1]. In addition, the results were compared with a matched background population.

Rectal cancer occurred in 42 of 4,931 IBD patients (0.9%) with a diverted rectum after subtotal colectomy. In IBD patients without colectomy, 209 of 49,251 (0.4%) received a diagnosis of rectal cancer. The background population demonstrated a similar ratio of rectal cancer (941 of 246,550 participants, 0.4%). After adjusting for IBD type and sex, the results showed that IBD patients with a diverted rectum had an increased risk of rectal cancer 10 years after surgery compared with IBD patients without colectomy (HR 7.93; 95% CI 5.48-11.48; P<0.0001). Similarly, 10 years after colectomy, IBD patients with a diverted rectum were more at risk of rectal cancer than the matched background population (HR 10.25; 95% CI 7.36-14.28; P<0.0001).

1. Akimenko E, et al. Rectal cancer risk 10 years after colectomy in patients with inflammatory bowel disease: a population-based Danish cohort study 1978-2018. P090, ECCO 2021 Virtual Congress, 2-3 & 8-10 July.

 

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Posted on 2 July 202117 May 2024