Ali RA, Dooley C, Comber H et al. Clin Gastroenterol Hepatol 2011;9:584–9.
It is known that IBD patients, particularly those with a longer disease duration and greater extent and severity of disease, have an increased risk of developing colorectal cancer (CRC). However, less is known about the clinical characteristics, treatment, and outcomes of these patients. This article describes a population-based study conducted in Ireland to investigate these features in IBD patients with CRC compared with those in non-IBD CRC patients.
The present authors conducted a population-based study to address whether persons with IBD and colorectal cancer (CRC) fare worse than persons with sporadic CRC. The National Cancer Registry of Ireland was used to collect data on all patients diagnosed with CRC from 1994–2005 (n=22 335). IBD patients within this cohort (n=170) were identified using Irish Hospital Inpatient Enquiry records. The clinical characteristics, treatment, and survival of patients with IBD and CRC were compared with those of non-IBD patients with CRC. Patients with CRC and IBD were a mean of 7.7 years younger than those without IBD at diagnosis of CRC (p=0.001). They were also less likely to smoke than the non-IBD CRC patients (p=0.002). More CRC cases in IBD were proximal to the splenic flexure (41%) compared with non-IBD CRC cases (29%). Fewer CRCs in patients with IBD were stage IV at diagnosis (12% vs. 22% in non-IBD patients; p<0.001). The authors review that their finding of less stage IV disease in IBD-related CRC is different than rates found in other large series from Denmark, Norway, and Olmsted County (MN, USA) where IBD and non-IBD CRC had comparable rates of stage IV CRC.