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DOI: 10.1055/s-0033-1347491
Risk of colorectal cancer in CD patients with colonic involvement and stenosing disease. 1977 – 2012. Results from a population-based study
Background and aims: Since data are limited our aim was to study the risk of colorectal cancer (CRC) in patients Crohn's disease (CD) presenting with stenosing colonic lesions in the population-based, Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008.
Methods: The data of 640 incident CD patients were analyzed (m/f: 321/319, age-at-diagnosis: 31.5, SD: 13.9 years). Both hospital and outpatient records were collected and comprehensively reviewed.
Results: CRC was diagnosed in total 6 CD patients (total follow-up: 7759 person-years) during follow-up. 62 patients presented with colonic/ileocolonic disease and a stenotic lesion in the colon. The total follow-up was 702 person-years (mean: 11.3 SD 8.1 years). CRC developed in 6.5%, equalling 0.57/100 person-years and an increased SIR (6.53, 95% CI: 2.45 – 17.4) with 4 patients observed and 0.61 expected. In a Kaplan-Meier analysis the probability of developing CRC was 5.5% after 5-years and 7.5% after 10-years of disease duration. In a sensitivity analysis, we included all patients who presented with colonic/ileocolonic disease and a stenosing colonic lesion at diagnosis or during follow-up (n = 91, total follow-up: 1180 person-years, mean: 12.9 SD 8.8 years). The prevalence of cancer was overall 4.4% (0.34/100 person-years). In a Kaplan-Meier analysis the probability of developing CRC was 3.6% and 4.9% after 5- and 10-years of disease duration.
Conclusions: The risk to develop CRC in colonic CD patients presenting with or developing a stenotic lesion in the colon is high already after relatively short disease duration suggesting the need for careful surveillance of these patients.