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Incidence and mortality of colorectal adenocarcinoma in persons with inflammatory bowel disease from 1998 to 2010
Lisa J Herrinton1, Liyan Liu, Theodore R Levin
1Kaiser Permanente Northern California, Oakland, CA, USA. Lisa.herrinton@kp.org
Gastroenterology
|May 22, 2012
Summary
Individuals with inflammatory bowel disease (IBD) have a 60% higher incidence of colorectal cancer (CRC) compared to the general population. This increased risk for CRC remained stable over time during the study period.
Area of Science:
- Gastroenterology
- Oncology
- Epidemiology
Background:
- The recent relationship between inflammatory bowel disease (IBD) and colorectal adenocarcinoma (CRC) incidence and mortality requires updated evaluation.
- IBD encompasses Crohn's disease (CD) and ulcerative colitis (UC), both chronic inflammatory conditions affecting the gastrointestinal tract.
Purpose of the Study:
- To evaluate the incidence and mortality rates of CRC in patients with IBD.
- To assess trends in CRC incidence and mortality in IBD patients compared to the general population.
- To examine changes in medication use and cancer detection rates over time within the IBD population.
Main Methods:
- Utilized Kaiser Permanente of Northern California data from 1998 to 2010 for members with IBD and the general population.
- Calculated incidence and standardized incidence and mortality rate ratios for CRC in adult individuals with intact colons.
- Analyzed trends in anti-tumor necrosis factor (anti-TNF) agent use and colonoscopy rates.
Main Results:
- Identified 29 CRC cases in Crohn's disease (CD) patients and 53 in ulcerative colitis (UC) patients.
- CRC incidence was 60% higher in IBD patients (CD and UC) compared to the general population (rate ratio: 1.6; 95% CI, 1.3-2.0).
- CRC incidence remained stable over time in IBD patients (CD P=.98, UC P=.40), contrasting with a 21% increase in the general population.
Conclusions:
- From 1998 to 2010, CRC incidence in IBD patients was consistently 60% higher than in the general population.
- The incidence of CRC in IBD patients remained stable throughout the study period.
- Standardized mortality ratios for CRC were elevated in both CD (2.3) and UC (2.0) patients.
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