Increased incidence of colorectal cancer and death in CD

Patients with Crohn’s disease (CD) have an increased risk of a colorectal cancer (CRC) and CRC-associated death [1]. CRC surveillance among CD patients could likely be improved, focusing on patients <40 years at CD onset, patients with colon inflammation, and patients with primary sclerosing cholangitis.

The aim of this nationwide register-based cohort study was to assess risks of tumour stage-adjusted incident CRC and CRC mortality among patients with CD compared with the general population. A total of 47,035 patients in Denmark (n=13,056) and Sweden (n=33,979) were compared with 463,187 matched reference individuals from the general population. During 1969–2017, 499 CD patients developed CRC (adjusted HR 1.40; 95% CI 1.27–1.53).

• In CD patients there were 296 (0.47/1000 person-years) deaths from CRC versus 1,968 (0.31/1000) in the reference group (HR 1.74; 95% CI 1.54–1.96).
• CD patients with CRC had a higher risk of CRC mortality than non-CD patients with CRC (HR 1.30; 95% CI 1.06–1.59) despite matched tumour stage at diagnosis.
• CD patients with ≥8 years of follow-up or who were diagnosed with primary sclerosing cholangitis had an increased overall risk of CRC death (HR 1.41; 95% CI 1.18–1.69) or CRC diagnosis (HR 1.12; 95% CI 0.98–1.28).
• In patients potentially eligible for CRC surveillance, risk of CRC death was only significantly increased in patients with CD onset <40 years, disease activity in the colon only, or with primary sclerosing cholangitis.

1. 
   
   1. 
      
      1. Olen O, et al. ECCO-IBD 2020, OP14.

Posted on 14 April 202018 March 2021