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Colorectal Cancer associated with pediatric inflammatory bowel disease: a case series
Min Jee Kim1, Jae Sung Ko1, Minsoo Shin1
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
Insights
Pediatric inflammatory bowel disease (IBD) patients diagnosed with colorectal cancer (CRC) had a shorter disease duration. Early surveillance endoscopy is recommended for pediatric IBD patients to detect CRC.
Area of Science:
- Gastroenterology
- Pediatric Oncology
- Clinical Epidemiology
Background:
- Inflammatory bowel disease (IBD) increases colorectal cancer (CRC) risk, influenced by disease duration and extent.
- Pediatric-onset IBD (PIBD) often presents more severely and for longer durations than adult-onset IBD.
- CRC in PIBD patients requires understanding clinical characteristics and evaluating current surveillance guidelines.
Purpose of the Study:
- To identify clinical features of CRC in patients with PIBD.
- To assess the appropriateness of current surveillance endoscopy recommendations for early CRC detection in PIBD.
Main Methods:
- Utilized the SUPREME electronic medical record data-mining system.
- Identified cases of colorectal malignancy in pediatric IBD patients between 2000 and 2020.
Main Results:
- Four out of 443 PIBD patients (1.29 per 1000 person-years) were diagnosed with CRC.
- Median age at CRC diagnosis was 18.5 years; median time from IBD diagnosis to CRC was 9.42 years.
- Sigmoid colon was the most frequent CRC location (3/4 cases); adenocarcinoma was the most common type (2/4 cases).
Conclusions:
- CRC in PIBD patients occurs with a significantly shorter disease duration compared to adult-onset IBD.
- Current surveillance endoscopy guidelines may need adjustment for earlier initiation in pediatric IBD patients.
Background:
Inflammatory bowel disease (IBD) is associated with an increased risk of Colorectal cancer (CRC), and its most important risk factors are the duration and extent of the disease. Pediatric-onset inflammatory bowel disease has a tendency for a more extensive, more severe, and longer predicted disease duration than adult-onset inflammatory bowel disease. This study aimed to identify the clinical characteristics of patients with CRC related to pediatric-onset IBD and consider the appropriateness of current surveillance endoscopy recommendations for the detection of premalignant lesions and early-stage CRC.
Methods:
We searched a research platform based on the SUPREME electronic medical record data-mining system to identify cases of colorectal malignancy in patients with pediatric IBD that presented between 2000 and 2020.
Results:
During the follow-up, 4 (1.29 per 1000 person years) out of 443 patients with PIBD was diagnosed with CRC. The median age at diagnosis of CRC was 18.5 (range: 15-24) years, and the median period from diagnosis of IBD to CRC was 9.42 (range: 0.44-11.96) years. The sigmoid colon was the most frequent location of CRC (in 3 of the 4 cases). Adenocarcinoma was the most common histological type (in 2 of the 4 cases).
Conclusions:
Patients with pediatric-onset IBD exhibited a much shorter disease duration than that of adult-onset IBD at the time of diagnosis of CRC, suggesting that surveillance endoscopy for the detection of precancerous lesions and early-stage cancer should be initiated earlier in pediatric patients than in adult patients.
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