Zamani Mohammad, Alizadeh-Tabari Shaghayegh
Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713135, Iran.
J Clin Med. 2023 Dec 27;13(1):148. doi: 10.3390/jcm13010148.
Although younger adults with inflammatory bowel disease (IBD) are known to have an increased risk of developing colorectal cancer (CRC), the impact of IBD on CRC risk in elderly patients is not yet fully understood. Therefore, we conducted this systematic review and meta-analysis to address this knowledge gap.
We thoroughly searched Embase, PubMed, and Scopus, covering the literature from inception to 31 August 2023, in any language. We enrolled population-based cohort studies that appraised the risk of CRC development in elderly patients (≥60 years) with IBD as compared to the non-IBD population. Our meta-analysis provided pooled relative risk (RR) with 95% confidence intervals (CIs) using a random-effect model.
Out of 3904 citations, 3 eligible cohort studies were ultimately included, reporting 694 CRC events in 35,187 patients with IBD. According to analysis, the risk of developing CRC did not increase in patients with elderly-onset IBD (RR = 1.17 [95% CI: 0.86-1.47]; I = 62.6%). This lack of a significant association was observed in both patients with Crohn's disease (RR = 1.28 [95% CI: 0.88-1.69]) and ulcerative colitis (RR = 0.99 [95% CI: 0.90-1.09]) ( for interaction = 0.166).
Our findings revealed no significant increase in the risk of incident CRC in patients with elderly-onset IBD, suggesting that intense screening of these patients for CRC may not be necessary.
虽然已知患有炎症性肠病（IBD）的年轻成年人患结直肠癌（CRC）的风险增加，但IBD对老年患者CRC风险的影响尚未完全了解。因此，我们进行了这项系统评价和荟萃分析，以填补这一知识空白。
我们全面检索了Embase、PubMed和Scopus，涵盖从创刊到2023年8月31日的任何语言的文献。我们纳入了基于人群的队列研究，这些研究评估了老年IBD患者（≥60岁）与非IBD人群相比患CRC的风险。我们的荟萃分析使用随机效应模型提供了合并相对风险（RR）及95%置信区间（CI）。
在3904条引用中，最终纳入了3项符合条件的队列研究，报告了35187例IBD患者中的694例CRC事件。根据分析，老年发病的IBD患者患CRC的风险没有增加（RR = 1.17 [95% CI：0.86 - 1.47]；I² = 62.6%）。在克罗恩病患者（RR = 1.28 [95% CI：0.88 - 1.69]）和溃疡性结肠炎患者（RR = 0.99 [95% CI：0.90 - 1.09]）中均观察到这种缺乏显著关联的情况（交互作用P = 0.166）。
我们的研究结果显示，老年发病的IBD患者发生CRC的风险没有显著增加，这表明对这些患者进行强化CRC筛查可能没有必要。
