Abu-Freha Naim, Cohen Bracha, Gordon Michal, Weissmann Sarah, Kestenbaum Emily H, Vosko Sergei, Abu-Tailakh Muhammad, Ben-Shoshan Liza, Cohen Daniel L, Shirin Haim
The Institute of Gastroenterology and Hepatology, Soroka University Medical Center, Beer-Sheva, Israel.
The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Front Med (Lausanne). 2023 Aug 7;10:1225616. doi: 10.3389/fmed.2023.1225616. eCollection 2023.
Colorectal cancer (CRC) is a feared complication of inflammatory bowel disease (IBD). We aimed to investigate the prevalence and risk factors of CRC among a large cohort of IBD patients.
Data on IBD patients free of CRC at baseline was extracted using the MDClone platform of the Clalit health maintenance organization in Israel. We investigated the frequency rate of CRC among IBD patients compared to a control group without IBD. Possible risk factors, including comorbidities and IBD-related medications, were investigated in a multivariate analysis.
During a follow-up of 139,448 years among Crohn's disease (CD) patients and 139,533 years among ulcerative colitis (UC) patients, a frequency rate of CRC was 1.5% (191) among 12,888 CD patients and 2.1% (261) among 12,381 UC patients compared to 1.2% among 57,334 controls. In a multivariate analysis of UC patients, age at diagnosis (OR 1.030, < 0.001), primary sclerosing cholangitis (OR 2.487, = 0.005), diabetes mellitus (OR 2.01, < 0.001), and glucocorticoids treatment (OR 1.465, = 0.008) were found to be predictors of CRC. For CD patients, age at diagnosis (OR 1.035, < 0.001), primary sclerosing cholangitis (OR 2.25, = 0.029), and glucocorticoids treatment (OR 2.07, < 0.001) were found to be predictors for CRC, but not diabetes mellitus.
Despite the continuously decreasing rates of CRC among IBD patients, these are still higher in IBD patients compared to the general population. IBD patients, particularly those with risk factors, require special consideration in follow-up for CRC.
结直肠癌（CRC）是炎症性肠病（IBD）令人担忧的并发症。我们旨在调查一大群IBD患者中CRC的患病率和危险因素。
使用以色列克拉利特健康维护组织的MDClone平台提取基线时无CRC的IBD患者的数据。我们调查了IBD患者中CRC的发生率，并与无IBD的对照组进行比较。在多变量分析中研究了可能的危险因素，包括合并症和IBD相关药物。
在克罗恩病（CD）患者139448人年的随访期以及溃疡性结肠炎（UC）患者139533人年的随访期内，12888例CD患者中CRC发生率为1.5%（191例），12381例UC患者中为2.1%（261例），而57334例对照组中为1.2%。在UC患者的多变量分析中，诊断时年龄（比值比1.030，P<0.001）、原发性硬化性胆管炎（比值比2.487，P=0.005）、糖尿病（比值比2.01，P<0.001）以及糖皮质激素治疗（比值比1.465，P=0.008）被发现是CRC的预测因素。对于CD患者，诊断时年龄（比值比1.035，P<0.001）、原发性硬化性胆管炎（比值比2.25，P=0.029）以及糖皮质激素治疗（比值比2.07，P<0.001）被发现是CRC的预测因素，但糖尿病不是。
尽管IBD患者中CRC的发生率持续下降，但与普通人群相比，IBD患者中的发生率仍然更高。IBD患者，尤其是那些有危险因素的患者，在CRC随访中需要特别关注。
