Outcomes From IBD-Associated and Non-IBD-Associated Colorectal Cancer

Gearhart, Susan L.; Nathan, Hari; Pawlik, Timothy M.; Wick, Elizabeth C.; Efron, Jonathan E.; Shore, Andrew D.

doi:10.1097/dcr.0b013e318242620f

Cited by 36 publications

(11 citation statements)

References 17 publications

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“…On the one hand, twelve of fifteen (80.0%) patients were diagnosed with CRC at surveillance colonoscopy, which is comparable with previous studies [22]. On the other hand, we found a higher proportion CRCs in stage IV and a lower proportion in stage I at diagnosis in comparison with other studies [22, 23], with proportions more similar to the nonsurveillance population of the study of Lutgens, though we cannot make any conclusion about it because of the small absolute number of CRCs in our cohort [22]. …”

Section: Discussionsupporting

confidence: 90%

A Thirty‐Year Follow‐Up Surveillance Study for Neoplasia of a Dutch Ulcerative Colitis Cohort

Stolwijk

Langers

Hardwick

et al. 2013

The Scientific World Journal

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Background. Patients with ulcerative colitis have an increased risk of developing colorectal cancer (CRC). The aim of this study is to assess the yield of surveillance colonoscopies in a tertiary referral cohort of ulcerative colitis patients and to identify different risk groups for dysplasia. Methods. A cohort of 293 patients (148 males, mean age 33.8 years at diagnosis) was built up at our center and started the surveillance program 8–12 years after start of symptoms. They underwent colonoscopies every one to three years. Endpoints were dysplasia or a (sub)total colectomy. Results. After a follow-up period of 10 years, the cumulative incidence of any dysplasia was 23.5%, and of CRC 4.0%. After 15 years these percentages were 33.3% and 6.8%. Patients with pancolitis (n = 178) had a significantly higher cumulative risk of dysplasia than patients with distal disease, HR 1.9 (95%CI 1.1–3.3). Patients who started surveillance at an older age are at increased risk for any dysplasia, HR 1.03 (95%CI 1.01–1.05). Conclusions. This prospective surveillance study shows a high yield of dysplasia in ulcerative colitis patients. We recommend developing separate surveillance programs for different risk groups. In our opinion patients with distal colitis can follow the general population surveillance program.

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Section: Discussionsupporting

confidence: 90%

A Thirty‐Year Follow‐Up Surveillance Study for Neoplasia of a Dutch Ulcerative Colitis Cohort

Stolwijk

Langers

Hardwick

et al. 2013

The Scientific World Journal

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“…These criteria have been used previously in prior studies. 11 , 13 Patients were excluded if they had discharge diagnoses of both UC and CD or were missing demographic information. The additional data from the NRD had the same inclusion and exclusion criteria.…”

Section: Methodsmentioning

confidence: 99%

“… 10 However, there is a dearth of literature on hospital outcomes of IBD patients undergoing surgery for CRC. 11 , 12 Thus, we hypothesized that the IBD patients with CRC who undergo surgery for CRC would have more frequent postsurgical complications and longer hospital courses compared to non-IBD patients with CRC.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Bowel Disease Adversely Impacts Colorectal Cancer Surgery Short-term Outcomes and Health-Care Resource Utilization

Ramsey

Krishna

Stanich

et al. 2017

Clinical and Translational Gastroenterology

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Objectives:Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer (CRC) compared to patients without IBD. There is a lack of population-based data evaluating the in-patient surgical outcomes of CRC in IBD patients. We sought to compare the hospital outcomes of CRC surgery between patients with and without IBD.Methods:We used the National Inpatient Sample (2008–2012) and Nationwide Readmissions Database (NRD, 2013) and selected all adult patients (age ≥18 years) with ulcerative colitis (UC) or Crohn’s disease (CD) who underwent CRC surgery. Multivariate analysis for in-patient outcomes of postoperative complications, health-care resource utilization, readmission rate, and mortality were performed.Results:A total of 397,847 patients underwent CRC surgery from 2008 to 2012, of which 0.8% (3,242) had IBD. Compared to CRC in non-IBD patients, CRC in IBD patients had longer length of stay (adjusted coefficient (AC) 0.86 days, 95% confidence interval (CI): 0.42, 1.30), more likely developed postoperative complications (adjusted odds ratio (AOR) 1.26, 95% CI: 1.06, 1.50), including postoperative infection (AOR 1.69, 95% CI: 1.20, 2.38) and deep vein thrombosis (AOR 2.42, 95% CI: 1.36, 4.28), and more frequently required blood transfusion (AOR 1.59, 95% CI: 1.30, 1.94). CRC in IBD patients was more likely to be readmitted within 30 days (AOR 1.44, 95% CI: 1.01, 2.04).Conclusion:At a population level, IBD adversely impacts outcomes at the time of CRC surgery.

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“…97-99 Sultan et al compared the prognosis of cancer in individuals with IBD with survival outcomes in SEER. 100 Other studies have compared IBD associated colorectal cancer (CRC) with sporadic CRC, 101, 102 or rates of early/missed cancers after colonoscopy in older patients with and without IBD. 103 While SEER itself could not be used as a surveillance system for IBD, this model could be extended to IBD related outcomes and complications, which are an important part of disease surveillance.…”

Section: Potential Methods Of Surveillancementioning

confidence: 99%

Challenges in Designing a National Surveillance Program for Inflammatory Bowel Disease in the United States

Long

Hutfless

Kappelman

et al. 2014

Inflammatory Bowel Diseases

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This review describes the history of US government funding for surveillance programs in IBD, provides current estimates of the incidence and prevalence of inflammatory bowel diseases (IBD) in the United States (US), and enumerates a number of challenges faced by current and future IBD surveillance programs. A rationale for expanding the focus of IBD surveillance beyond counts of incidence and prevalence, in order to provide a greater understanding of the burden of IBD, disease etiology and pathogenesis, is provided. Lessons learned from other countries are summarized, as well as potential resources that may be used to optimize a new form of IBD surveillance in the US. A consensus recommendation on the goals and available resources for a new model for disease surveillance are provided. This new model should focus upon “surveillance of the burden of disease,” including 1) natural history of disease and 2) outcomes and complications of the disease and/or treatments.

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Outcomes From IBD-Associated and Non-IBD-Associated Colorectal Cancer

Abstract: Older patients with IBD-associated colorectal cancer appear to have a slightly worse outcome than those with sporadic colorectal cancer. The cause of this is multifactorial, but it does not appear to be associated with a more limited surgical resection.

Cited by 36 publications

References 17 publications

A Thirty‐Year Follow‐Up Surveillance Study for Neoplasia of a Dutch Ulcerative Colitis Cohort

A Thirty‐Year Follow‐Up Surveillance Study for Neoplasia of a Dutch Ulcerative Colitis Cohort

Inflammatory Bowel Disease Adversely Impacts Colorectal Cancer Surgery Short-term Outcomes and Health-Care Resource Utilization

Challenges in Designing a National Surveillance Program for Inflammatory Bowel Disease in the United States

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