Letter: glucocorticoids use and the risk of colorectal cancer

Abstract

attractive for its use in clinical practice, with the advantages of avoiding venous puncture, on one hand, and providing the results immediately, on the other. However, it seems to have some limitations. Of note, the concentration of the antibodies against the drug, which is essential for decision making in patients under antiTNFa treatment, could not be measured with this test.2, 8 Furthermore, as the authors recognise, the accuracy of this new test needs to be validated.In conclusion, the best method for measuring antiTNFa and antibody levels remains to be established, and the impact of monitoring anti-TNFa therapies based on serum levels needs to be proven. The development of new tests to make this measurement more feasible will facilitate the implementation of this strategy in the clinical management of patients receiving anti-TNFa therapies. ACKNOWLEDGEMENTThe authors' declarations of personal and financial interests are unchanged from those in the original article.

From No Disease to Stage IV Colon Cancer in Four Months: A Case Report

“…In contrast, Ostenfeld et al performed a case-control study in Northern Denmark where they found that frequent use of systemic glucocorticoids (defined as >2 prescriptions) was not associated with the risk of CRC [ 8 ]. However, Lai et al responded to this by showing that in their cohort study conducted in the Taiwanese population, oral use, injection use, and the topical use of glucocorticoids and the risk of colon cancer were in fact associated since the case group had a higher incidence of CRC as per the control group (IR 1.16 vs 0.81 per 1000 person-years, 95% CI=1.30, 1.58) [ 9 ]. This conflicting result of two big studies in different populations with the addition of the case report presented should spark further investigation on this matter to confirm the present role of glucocorticoid use on the risk of CRC as well as the speed of progression.…”

Colorectal cancer among inflammatory bowel disease patients: risk factors and prevalence compared to the general population

“…The mechanism of glucocorticoids on CRC could be related to the suppression of the host’s immune system and impact on colorectal cancer cells. The impact of glucocorticoids signaling on intestinal tumorigenesis remains controversial ( 29 , 30 ); however, one previous study demonstrated that intestinal epithelial GR signaling repressed acute colitis but promoted chronic inflammation-associated colorectal cancer ( 31 ). Alternatively, using steroids may be a surrogate representing either a more severe or poorly controlled disease.…”

Intestinal epithelial glucocorticoid receptor promotes chronic inflammation–associated colorectal cancer

“…On the one hand, a nested population-based cohort study by Ostenfeld et al found that frequent use of systemic GCs was not associated with an increased overall risk of colorectal cancer in Northern Denmark (24). On the other hand, another population-based cohort study by Lai et al reported that oral, injected, and/or topical GC use for 1-5 years before diagnosis significantly increased the risk of colorectal cancer in Taiwanese population (25).…”

“…On one hand, a nested population-based cohort study by Ostenfeld et al found that frequent use of systemic GCs was not associated with an increased overall risk of colorectal cancer in Northern Denmark ( 24 ). On the other hand, another population-based cohort study by Lai et al reported that oral, injected, and/or topical GC use for 1–5 years before diagnosis significantly increased the risk of colorectal cancer in a Taiwanese population ( 25 ). Because of these discrepancies, understanding the causal relationship between GR signaling and chronic inflammation–associated colorectal cancer in vivo will be important for clinical management of IBD and colorectal cancer.…”