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Age at diagnosis influences development of colorectal cancer in IBD

Age at diagnosis of IBD influences early development of colorectal cancer in IBD patients, reports December's issue of the Journal of Gastroenterology.

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Data on clinical characteristics of patients with inflammatory bowel disease (IBD)-related colorectal cancer are scarce, and mainly originate from tertiary referral centers.

Dr Baars and colleagues from The Netherlands studied patient and disease characteristics of inflammatory bowel disease-related colorectal cancer in a nationwide inflammatory bowel disease cohort in general hospitals.

The team's main outcome parameters were time to develop colorectal cancer, and factors associated with early colorectal cancer development.

All inflammatory bowel disease patients diagnosed with colorectal cancer between 1990 and 2006 were identified using a nationwide automated pathology database.

89 of 251 patients developed early colorectal cancer
Journal of Gastroenterology

The team of researchers assessed patient's charts to confirm diagnosis and collect clinical data.

Early colorectal cancer was defined as colorectal cancer diagnosed less than 8 years after inflammatory bowel disease diagnosis..

Diagnosis of inflammatory bowel disease-related colorectal cancer was confirmed in 251 patients.

The researchers noted that the median time from inflammatory bowel disease diagnosis to colorectal cancer diagnosis was 12 years, and that 89 patients developed early colorectal cancer.

Type of inflammatory bowel disease, gender, concomitant PSC, pseudopolyps, extent of inflammation, and medication use were not related to early colorectal cancer.

The doctors noted that inflammatory bowel disease diagnosis at older age was related to early colorectal cancer.

The research team found that 23 patients had been included in a surveillance programme prior to colorectal cancer diagnosis.

Patients in the surveillance group had a significantly better tumor stage.

Dr Baars' team concludes, "We emphasize the problem of a high proportion of inflammatory bowel disease-associated colorectal cancers developing before the recommended start of surveillance."

"Therefore, we suggest that older age at inflammatory bowel disease onset could be an additional factor to start surveillance in inflammatory bowel disease patients."

Journal of Gastroenterology 2012:47(12):1308-1322
09 January 2013

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