Z Gastroenterol 2013; 51 - A41
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

B Lovasz 1, L Lakatos 2, P Golovics 1, G David 2, T Pandur 2, Z Erdelyi 2, G Mester 3, M Balogh 3, I Szita 2, C Molnar 4, E Komaromi 5, Z Vegh 1, M Mandel 1, L Kiss 1, P Lakatos 1
  • 1Semmelweis University, 1st Department of Medicine, Budapest
  • 2Department of Medicine, Csolnoky F. Province Hospital, Veszprem, Hungary
  • 3Department of Medicine, Grof Eszterhazy Hospital, Papa, Hungary
  • 4Department of Infectious Diseases, Magyar Imre Hospital, Ajka, Hungary
  • 5Department of Gastroenterology Municipal Hospital, Varpalota, Hungary

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.