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."