Low Risk for Colorectal Cancer in Patients with Inflammatory Bowel Disease

Hospital-based data from the Netherlands confirm low risk and reveal protective effects of immunosuppressive thiopurines and antitumor necrosis factor.


Ulcerative colitis and Crohn colitis are widely acknowledged risk factors for development of colorectal cancer (CRC). However, results of population-based studies have suggested that the risk is overestimated (JW Gastroenterol May 9 2006 and World J Gastroenterol 2008; 14:3937), which might arise from research conducted in referral centers, where patients have more-severe or more-extensive inflammatory bowel disease (IBD).

To assess the risk for CRC among patients with IBD in a broader patient population, researchers conducted a nested case-control study in all 93 general hospitals in the Netherlands. Cases were identified through a nationwide network and registry of histo- and cytopathology reports; controls, chosen from 22 randomly selected hospitals, had histologically confirmed IBD but no diagnosis of CRC.

Of a total of 26,855 patients with IBD among 58 hospitals, 163 developed CRC during 15.5 years, for an incidence rate of 0.04% per year. Factors associated with an increased risk for CRC included presence and duration of primary sclerosing cholangitis, duration of IBD, and pseudopolyps at colonoscopy. Protective factors were immunosuppressive therapy (odds ratio, 0.3) and antitumor necrosis factor agents (OR, 0.09). A protective effect from 5-aminosalicylic could not be demonstrated.


Citation(s):

Baars JE et al. The risk of inflammatory bowel disease-related colorectal carcinoma is limited: Results from a nationwide nested case–control study. Am J Gastroenterol 2011 Feb; 106:319.