Predictive and protective factors associated with colorectal cancer in chronic ulcerative colitis are not well described.
Surveillance colonoscopy and 5-aminosalicylic acid therapy may mitigate cancer risk.
However, there is debate because these variables have not been evaluated in the same study.
The presence of postinflammatory pseudopolyps and other anti-inflammatory medications may be important variables that influence risk, but data are sparse.
Dr Edward Loftus and colleagues from Minnesota assessed variables associated with colorectal cancer.
| Corticosteroids and aspirin use were associated with colorectal cancer|
The patients included 188 patients with ulcerative colitis-related cancer and matched controls.
The research team used conditional logistic regression, and adjusted for age at colitis diagnosis and colitis duration.
The team identified a final set of variables independently associated with colorectal cancer.
In the final multiple variable model, one of the most important factors associated with colorectal cancer was a history of pseudopolyps.
The researchers found that 1 or 2 surveillance colonoscopies, smoking, use of corticosteroids, and aspirin use were also associated with colorectal cancer.
Use of nonsteroidal anti-inflammatory drugs, and 5-aminosalicylic acid agents were linked to colorectal cancer, but the latter was not significant after 5 years.
The team noted that primary sclerosing cholangitis and immunosuppressive use were not statistically significant.
Dr Loftus' team concluded, “These results suggest that, in a population matched for extent and duration of chronic ulcerative colitis, surveillance colonoscopy and use of anti-inflammatory medications may reduce the risk of colorectal cancer.”
“A history of postinflammatory pseudopolyps appears to be a predictive factor for cancer.”