Long-term follow up reveals low incidence of colorectal cancer, but frequent need for resection, among Australian patients with inflammatory bowel disease

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https://doi.org/10.1016/j.cgh.2013.05.017
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Keywords

Crohn's disease, ulcerative colitis, inflammatory bowel disease, surgery, colorectal cancer

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Long-term follow up reveals low incidence of colorectal cancer, but frequent need for resection, among Australian patients with inflammatory bowel disease. / Sydney IBD Cohort Study Group.
In: Clinical Gastroenterology and Hepatology, Vol. 12, No. 4, 04.2014, p. 644-650.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Bibtex

@article{81c23756a3fc41b2aec48182ef42d39f,

title = "Long-term follow up reveals low incidence of colorectal cancer, but frequent need for resection, among Australian patients with inflammatory bowel disease",

abstract = "Background & Aims:Inflammatory bowel disease (IBD) can require surgical resection and also lead to colorectal cancer (CRC). We investigated the cumulative incidence of resection surgeries and CRC among patients with ulcerative colitis (UC) or Crohn{\textquoteright}s disease (CD).Methods: We analyzed data from a cohort of patients who participated in an IBD study (504 with UC and 377 with CD) at 2 academic medical centers in Sydney, Australia from 1977 to 1992 (before the development of biologic therapies). We collected follow-up data on surgeries and development of CRC from hospital and community medical records or via direct contact with patients, over a median time period of 14 y. Cumulative incidences of resection surgeries and CRC were calculated by competing risk survival analysis.Results: Among patients with UC, CRC developed in 24, for a cumulative incidence of 1% at 10 y (95% confidence interval [CI], 0−2%), 3% at 20 y (95% CI, 1%−5%), and 7% at 30 y (95% CI, 4%−10%). Their cumulative incidence of colectomy was 15% at 10 y (95% CI, 11%−19%), 26% at 20 y (95% CI, 21%−30%) and 31% at 30 y (95% CI, 25%−36%). Among patients with CD, 5 of 327 with colon disease developed CRC, with a cumulative incidence of CRC of 1% at 10 y (95% CI, 0−2%), 1% at 20 y (95% CI, 0−2%), and 2% at 30 y (95% CI, 0−4%). Among all patients with CD, the cumulative incidence of resection was 32% at 5 y (95% CI, 27%−37%), 43% at 10 y (95% CI, 37%−49%), and 53% at 15 y (95% CI, 46%−58%). Of these 168 subjects, 42% required a 2nd resection within 15 y of the first surgery (95% CI, 33%−50%).Conclusion: Patients with UC have a low incidence of CRC over a 30 y period (7% or less); the incidence among patients with CD is even lower. However, almost one third of patients with UC and about 50% of those with CD will require surgery.",

keywords = "Crohn's disease, ulcerative colitis, inflammatory bowel disease, surgery, colorectal cancer",

author = "Christian Selinger and Jane Andrews and Andrew Titman and Ian Norton and Jones, {D. Brian} and Charles McDonald and Gavin Barr and Warwick Selby and Leong, {Rupert W.} and {Sydney IBD Cohort Study Group}",

year = "2014",

month = apr,

doi = "10.1016/j.cgh.2013.05.017",

language = "English",

volume = "12",

pages = "644--650",

journal = "Clinical Gastroenterology and Hepatology",

issn = "1542-3565",

publisher = "W.B. Saunders Ltd",

number = "4",

}

RIS

TY - JOUR

T1 - Long-term follow up reveals low incidence of colorectal cancer, but frequent need for resection, among Australian patients with inflammatory bowel disease

AU - Selinger, Christian

AU - Andrews, Jane

AU - Titman, Andrew

AU - Norton, Ian

AU - Jones, D. Brian

AU - McDonald, Charles

AU - Barr, Gavin

AU - Selby, Warwick

AU - Leong, Rupert W.

AU - Sydney IBD Cohort Study Group

PY - 2014/4

Y1 - 2014/4

N2 - Background & Aims:Inflammatory bowel disease (IBD) can require surgical resection and also lead to colorectal cancer (CRC). We investigated the cumulative incidence of resection surgeries and CRC among patients with ulcerative colitis (UC) or Crohn’s disease (CD).Methods: We analyzed data from a cohort of patients who participated in an IBD study (504 with UC and 377 with CD) at 2 academic medical centers in Sydney, Australia from 1977 to 1992 (before the development of biologic therapies). We collected follow-up data on surgeries and development of CRC from hospital and community medical records or via direct contact with patients, over a median time period of 14 y. Cumulative incidences of resection surgeries and CRC were calculated by competing risk survival analysis.Results: Among patients with UC, CRC developed in 24, for a cumulative incidence of 1% at 10 y (95% confidence interval [CI], 0−2%), 3% at 20 y (95% CI, 1%−5%), and 7% at 30 y (95% CI, 4%−10%). Their cumulative incidence of colectomy was 15% at 10 y (95% CI, 11%−19%), 26% at 20 y (95% CI, 21%−30%) and 31% at 30 y (95% CI, 25%−36%). Among patients with CD, 5 of 327 with colon disease developed CRC, with a cumulative incidence of CRC of 1% at 10 y (95% CI, 0−2%), 1% at 20 y (95% CI, 0−2%), and 2% at 30 y (95% CI, 0−4%). Among all patients with CD, the cumulative incidence of resection was 32% at 5 y (95% CI, 27%−37%), 43% at 10 y (95% CI, 37%−49%), and 53% at 15 y (95% CI, 46%−58%). Of these 168 subjects, 42% required a 2nd resection within 15 y of the first surgery (95% CI, 33%−50%).Conclusion: Patients with UC have a low incidence of CRC over a 30 y period (7% or less); the incidence among patients with CD is even lower. However, almost one third of patients with UC and about 50% of those with CD will require surgery.

AB - Background & Aims:Inflammatory bowel disease (IBD) can require surgical resection and also lead to colorectal cancer (CRC). We investigated the cumulative incidence of resection surgeries and CRC among patients with ulcerative colitis (UC) or Crohn’s disease (CD).Methods: We analyzed data from a cohort of patients who participated in an IBD study (504 with UC and 377 with CD) at 2 academic medical centers in Sydney, Australia from 1977 to 1992 (before the development of biologic therapies). We collected follow-up data on surgeries and development of CRC from hospital and community medical records or via direct contact with patients, over a median time period of 14 y. Cumulative incidences of resection surgeries and CRC were calculated by competing risk survival analysis.Results: Among patients with UC, CRC developed in 24, for a cumulative incidence of 1% at 10 y (95% confidence interval [CI], 0−2%), 3% at 20 y (95% CI, 1%−5%), and 7% at 30 y (95% CI, 4%−10%). Their cumulative incidence of colectomy was 15% at 10 y (95% CI, 11%−19%), 26% at 20 y (95% CI, 21%−30%) and 31% at 30 y (95% CI, 25%−36%). Among patients with CD, 5 of 327 with colon disease developed CRC, with a cumulative incidence of CRC of 1% at 10 y (95% CI, 0−2%), 1% at 20 y (95% CI, 0−2%), and 2% at 30 y (95% CI, 0−4%). Among all patients with CD, the cumulative incidence of resection was 32% at 5 y (95% CI, 27%−37%), 43% at 10 y (95% CI, 37%−49%), and 53% at 15 y (95% CI, 46%−58%). Of these 168 subjects, 42% required a 2nd resection within 15 y of the first surgery (95% CI, 33%−50%).Conclusion: Patients with UC have a low incidence of CRC over a 30 y period (7% or less); the incidence among patients with CD is even lower. However, almost one third of patients with UC and about 50% of those with CD will require surgery.

KW - Crohn's disease

KW - ulcerative colitis

KW - inflammatory bowel disease

KW - surgery

KW - colorectal cancer

U2 - 10.1016/j.cgh.2013.05.017

DO - 10.1016/j.cgh.2013.05.017

M3 - Journal article

VL - 12

SP - 644

EP - 650

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 4

ER -

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