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Incidence and Neoplastic Risk Associated with Colonic Stricture in Paediatric-Onset Crohn's Disease: A
Nicolas Richard1, Ariane Leroyer2, Claire Dupont3
1Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073, "Nutrition, Inflammation and microbiota-gut-brain axis", CHU Rouen, Department of Gastroenterology, F-76000 Rouen, France.
Clinics and Research in Hepatology and Gastroenterology
|April 22, 2026
Summary
Colonic strictures in pediatric Crohn's disease (CD) are uncommon and rarely lead to colorectal cancer (CRC). This study found a low incidence of strictures and minimal CRC risk in pediatric CD patients.
Area of Science:
- Gastroenterology
- Pediatric Gastroenterology
- Oncology
Background:
- Colonic strictures in Crohn's disease (CD) often prompt surgery due to colorectal cancer (CRC) concerns.
- Limited data exist on CRC risk associated with colonic strictures, especially in pediatric-onset CD.
Purpose of the Study:
- To determine the incidence of colonic stricture in pediatric CD patients.
- To describe the natural history of colonic strictures.
- To assess the risk of CRC in this population.
Main Methods:
- Retrospective analysis of a population-based registry of patients diagnosed with CD before age 17.
- Follow-up until 2013 to identify colonic strictures (defined by endoscopic or radiological narrowing).
- Risk factors analyzed using Cox proportional hazards models.
Main Results:
- 5.1% of 1,007 pediatric CD patients developed colonic strictures.
- Cumulative incidence at 5 years was 2.9%.
- Risk factors included active disease periods; protective factors included aminosalicylate treatment and absence of colonic involvement at diagnosis. CRC was detected in only one patient (2%) within 6 months of stricture diagnosis.
Conclusions:
- Colonic strictures are infrequent in pediatric-onset CD.
- The risk of developing colorectal cancer following a colonic stricture in this cohort is low.
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