Impact of inflammatory bowel disease and primary sclerosing cholangitis on colorectal cancer risk:national cohort study.

IF 11.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology Pub Date : 2025-07-22 DOI:10.1016/j.cgh.2025.06.037

Maie Abdalla, Michael Eberhardson, Kalle Landerholm, Roland E Andersson, Pär Myrelid

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引用次数: 0

Abstract

Background and aims: Inflammatory bowel disease (IBD) increases the risk of colorectal cancer (CRC). Previous studies concluded primary sclerosing cholangitis (PSC) as an independent risk factor for CRC in IBD. We aimed to investigate the impact of IBD and PSC on the risk of developing CRC, mortality and colectomy.

Methods: IBD patients diagnosed 1969-2014 were identified from the Swedish National Patient Register, together with five matched controls per case from the background population. We estimated the impact of some risk factors including PSC+/- on the risk of CRC and mortality in the IBD patients compared to that in the controls, and colectomy within the IBD cohort.

Results: Among all IBD patients, the hazard ratio (HR) of CRC was 1.83 (95% CI 1.72-1.96, p<0.001). The risk was highest in the PSC+ patients initially but decreased over time. PSC+ patients diagnosed with IBD ≤ 20 years of age had a highly increased risk with an incidence rate ratio (IRR) of 74.97 (95% CI 44.7-126.1, p<0.001) compared to controls. PSC+ patients had 9-16 times higher risk of cancer in caecum/ascending, transverse and descending colon compared to sporadic CRC among controls. Synchronous cancer was found in 4.7% of PSC+, 4.4% of PSC- patients and 1.9% among controls (p< 0.001).

Conclusions: IBD patients have an increased risk of CRC, mostly prominent among young PSC+ patients. PSC+ patients display a tendency to develop CRC in the proximal colon and more synchronous CRC. This should be considered when monitoring and counselling IBD patients.

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炎症性肠病和原发性硬化性胆管炎对结直肠癌风险的影响：国家队列研究

背景和目的：炎症性肠病（IBD）增加结直肠癌（CRC）的风险。先前的研究认为原发性硬化性胆管炎（PSC）是IBD中结直肠癌的独立危险因素。我们的目的是研究IBD和PSC对结直肠癌发生风险、死亡率和结肠切除术的影响。方法：从瑞典国家患者登记册中确定1969-2014年诊断的IBD患者，以及背景人群中每个病例的5个匹配对照。我们估计了一些危险因素的影响，包括PSC+/-对IBD患者的结直肠癌风险和死亡率的影响，与对照组相比，IBD队列中的结肠切除术。结果：在所有IBD患者中，发生CRC的风险比（HR）为1.83 （95% CI 1.72-1.96）。结论：IBD患者发生CRC的风险增加，以年轻PSC+患者最为突出。PSC+患者倾向于在结肠近端发生结直肠癌和更多的同步结直肠癌。在监测和咨询IBD患者时应考虑到这一点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

16.90

自引率

4.80%

发文量

903

审稿时长

22 days

期刊介绍： Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.