Risk factors for colorectal neoplasia in inflammatory bowel disease: a nested case-control study from Copenhagen county, Denmark and Olmsted county, Minnesota
Research output: Contribution to journal › Journal article › Research › peer-review
OBJECTIVES: Population-based data on risk factors and protective factors for colorectal dysplasia and cancer in patients with inflammatory bowel disease (IBD) are sparse. We conducted a nested case-control study of such factors in two well-described IBD cohorts from Copenhagen County, Denmark and Olmsted County, Minnesota.
METHODS: Forty-three neoplasia cases were matched on six criteria to 1-3 controls (N = 102). Medical records were scrutinized for demographic and clinical data. For each variable, the odds of neoplasia were estimated using conditional logistic regression.
RESULTS: Primary sclerosing cholangitis (PSC) (odds ratio [OR] 6.9, 95% confidence interval [CI] 1.2-40), percentage of disease course with clinically active disease (OR [per 5% increase] 1.2, 95% CI 0.996-1.4), and >or=1 yr of continuous symptoms (OR 3.2, 95% CI 1.2-8.6) were associated with neoplasia, whereas a borderline association with median number of small-bowel x-rays (OR 1.3, 95% CI 0.96-1.6) was observed. We did not observe a protective effect of frequency of physician visits (OR 1.4, 95% CI 0.96-2.0), number of colonoscopies (OR 1.4, 95% CI 1.0-2.1), cumulative dose of sulfasalazine (OR [per 1,000 g] 1.1, 95% CI 1.0-1.3) and mesalamine (OR [per 1,000 g] 1.3, 95% CI 0.9-1.9), or partial intestinal resections (OR 1.5, 95% CI 0.3-7.1).
CONCLUSIONS: Subgroups of IBD patients-those with PSC, severe long-standing disease, and exposure to x-ray-were at greater risk of colorectal neoplasia. The protective effect of close follow-up, colonoscopy, and treatment with 5-aminosalicylates was questionable.
Original language | English |
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Journal | The American Journal of Gastroenterology |
Volume | 102 |
Issue number | 4 |
Pages (from-to) | 829-36 |
Number of pages | 8 |
ISSN | 0002-9270 |
DOIs | |
Publication status | Published - Apr 2007 |
- Adult, Case-Control Studies, Colonoscopy, Colorectal Neoplasms/epidemiology, Denmark/epidemiology, Female, Gastrointestinal Agents/therapeutic use, Humans, Inflammatory Bowel Diseases/complications, Logistic Models, Male, Mesalamine/therapeutic use, Minnesota/epidemiology, Population Surveillance, Precancerous Conditions/epidemiology, Prognosis, Risk Factors, Sulfasalazine/therapeutic use
Research areas
ID: 219529680