Risk of intestinal cancer in inflammatory bowel disease: a population-based study from olmsted county, Minnesota.

BACKGROUND & AIMS The risk for colorectal cancer in Crohn's disease and ulcerative colitis patients from the United States currently is unknown. We estimated the risk for small-bowel and colorectal cancer in a population-based cohort of 692 inflammatory bowel disease patients from Olmsted County, Minnesota, from 1940 to 2001. METHODS The Rochester Epidemiology Project was used to identify cohort patients with colorectal and small-bowel cancer. The cumulative probability of cancer and standardized incidence ratios (SIR) were estimated using expected rates from Surveillance, Epidemiology, and End Results, white patients from Iowa, from 1973 to 2000, and Olmsted County, from 1980 to 1999. RESULTS Colorectal cancer was observed in 6 ulcerative colitis patients vs 5.38 expected (SIR, 1.1; 95% confidence interval [CI], 0.4-2.4), but 4 of these occurred among those with extensive colitis or pancolitis (SIR, 2.4; 95% CI, 0.6-6.0). Six Crohn's disease patients (vs 3.2 expected) developed colorectal cancer (SIR, 1.9; 95% CI, 0.7-4.1). Three Crohn's disease patients developed small-bowel cancer vs 0.07 expected (SIR, 40.6; 95% CI, 8.4-118). CONCLUSIONS The risk for colorectal cancer was not increased among ulcerative colitis patients overall, but appeared to be increased among those with extensive colitis. The colorectal cancer risk was increased slightly among Crohn's disease patients, who also had a 40-fold excess risk for small-bowel cancer.

[1]  S. Kersting,et al.  Intestinal cancer in patients with Crohn’s disease , 2007, International Journal of Colorectal Disease.

[2]  L. Melton,et al.  Changing trends in the incidence, stage, survival, and screen-detection of colorectal cancer: a population-based study. , 2005, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[3]  P. Munkholm,et al.  Long-term risk of cancer in ulcerative colitis: a population-based cohort study from Copenhagen County. , 2004, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[4]  P. Munkholm,et al.  Intestinal and extra‐intestinal cancer in Crohn's disease: follow‐up of a population‐based cohort in Copenhagen County, Denmark , 2004, Alimentary pharmacology & therapeutics.

[5]  L. Melton,et al.  Update on incidence and prevalence of Crohn's disease (CD) and ulcerative colitis (UC) in olmsted county, minnesota , 2003 .

[6]  K. Abrams,et al.  The risk of colorectal cancer in ulcerative colitis: a meta-analysis , 2001, Gut.

[7]  E. Kliewer,et al.  Cancer risk in patients with inflammatory bowel disease , 2001, Cancer.

[8]  J. H. Baron Inflammatory bowel disease up to 1932. , 2000, The Mount Sinai journal of medicine, New York.

[9]  A. Zinsmeister,et al.  Ulcerative colitis in Olmsted County, Minnesota, 1940–1993: incidence, prevalence, and survival , 2000, Gut.

[10]  K. Abrams,et al.  Colorectal cancer prevention in ulcerative colitis: a case‐control study , 2000, Alimentary pharmacology & therapeutics.

[11]  R. Löfberg,et al.  Increased risk of cancer in ulcerative colitis: a population-based cohort study. , 1999 .

[12]  A. Zinsmeister,et al.  Crohn's disease in Olmsted County, Minnesota, 1940-1993: incidence, prevalence, and survival. , 1998, Gastroenterology.

[13]  S. Travis Review article: insurance risks for patients with ulcerative colitis or Crohn's disease , 1997, Alimentary pharmacology & therapeutics.

[14]  L. Melton,et al.  History of the Rochester Epidemiology Project. , 1996, Mayo Clinic proceedings.

[15]  A. Ahlbom,et al.  Crohn's disease and cancer: a population-based cohort study. , 1994, Gastroenterology.

[16]  P. Prior,et al.  Ulcerative colitis and Crohn's disease: a comparison of the colorectal cancer risk in extensive colitis. , 1994, Gut.

[17]  P. Prior,et al.  Crohn's disease and colorectal cancer. , 1994, Gut.

[18]  H. Adami,et al.  Ulcerative colitis and colorectal cancer. A population-based study. , 1990, The New England journal of medicine.

[19]  H. Adami,et al.  Increased risk of large-bowel cancer in Crohn's disease with colonic involvement , 1990, The Lancet.

[20]  Z. Fireman,et al.  Intestinal cancer in patients with Crohn's disease. A population study in central Israel. , 1989, Scandinavian journal of gastroenterology.

[21]  Z. Fireman,et al.  Colorectal cancer in patients with ulcerative colitis: A population study in central Israel , 1988 .

[22]  L. Melton,et al.  Epidemiologic aspects of Crohn's disease: a population based study in Olmsted County, Minnesota, 1943-1982. , 1988, Gut.

[23]  R. Löfberg,et al.  The risk of colorectal cancer in ulcerative colitis. An epidemiologic study. , 1987, Scandinavian journal of gastroenterology.

[24]  L. Melton,et al.  Prognosis of chronic ulcerative colitis in a community. , 1987, Gut.

[25]  D. Sachar,et al.  A comparison of cancer risk in crohn's disease and ulcerative colitis , 1981, Cancer.

[26]  J. Macartney,et al.  Malignancy in Crohn's disease. , 1980, British journal of preventive & social medicine.

[27]  W. Taylor,et al.  Crohn's disease and cancer. , 1973, The New England journal of medicine.

[28]  C. Wells,et al.  Ulcerative colitis and Crohn's disease. , 1952, Annals of the Royal College of Surgeons of England.

[29]  B. Crohn,et al.  The sigmoidoscopic picture of chronic ulcerative colitis (non-specific) , 1925 .

[30]  A. Ekbom Ulcerative Colitis and Colorectal Cancer , 1991 .