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Patients with inflammatory bowel disease (IBD) have an increased risk for colorectal cancer. Previous studies on early/missed CRCs after colonoscopy excluded IBD patients. Dr Yize Wang and colleagues compared the rate of early/missed colorectal cancers after colonoscopy among IBD and non-IBD patients, and identified factors associated with early/missed colorectal cancer. All patients in the Surveillance, Epidemiology and End-Results Medicare-linked database who were 67 years or older at colonoscopy during 1998–2005, and those who were subsequently diagnosed with colorectal cancer within 36 months were identified. Colorectal cancers diagnosed within 6 months of colonoscopy were categorized as detected colorectal cancers.  | | The rate of early/missed colorectal cancers was 6% for non-IBD patients | | American Journal of Gastroenterology |
The team diagnosed colorectal cancers 6–36 months after colonoscopy were categorized as early/missed colorectal cancers. The research team rated early/missed colorectal cancers was calculated as number of early/missed colorectal cancers divided by number of detected, and early/missed colorectal cancers.
Of 55,008 colorectal cancers patients, the rate of early/missed colorectal cancers was 6% for non-IBD patients, 15% for Crohn's, and 16% for ulcerative colitis. Compared with older non-IBD patients, early/missed colorectal cancers among older IBD patients were less likely right-sided. The researchers found that the risk of early/missed colorectal cancers was 3 times as high for IBD patients. Sensitivity analyses confirmed the robustness of this finding. Dr Wang's team commented, "Older IBD patients had a higher rate of early/missed colorectal cancers after colonoscopy. Our finding supports intensive surveillance colonoscopy for older IBD patients as recommended by guidelines."
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