Abstract
Objective We assessed the risk of colorectal cancer (CRC) in patients with ulcerative colitis (UC) using the nationwide population-based claims data. Materials and methods We analyzed the claims data of the Korean National Health Insurance (2006–2015). UC and CRC were defined using ICD-10 codes and UC-specific prescriptions in this study. Age- and sex-matched individuals without UC were randomly selected from the general population. Hazard ratios (HRs), adjusted for different covariates, were calculated using multivariate Cox proportional hazard regression. Results In total, 30,546 and 88,829 individuals with and without UC, respectively, were enrolled. CRC developed in 85 (0.27%) among UC, and 340 (0.38%) among individuals without UC, respectively. The HR (95% confidence interval [CI]) of CRC in all UC patients was 0.74 (0.58–0.94). Further, UC patients were stratified according to sex (male vs. female: 0.60 [0.44–0.82] vs. 1.10 [0.75–1.61]) and age (HR = 14.37, 2.74, 0.58, and 0.70 for 0–19, 20–39, 40–59, and ≥60 years, respectively). HR was significantly higher for late-onset UC (≥60 years) than for early-onset UC (0–19 years). The long duration of 5-aminosalicylic acid use had a significantly low HR, with reference to the 1st quartile. Conclusions The risk of CRC varies with age and sex in Korean patients with UC during the first decade after diagnosis. Early-onset UC (<40 years) increases the CRC risk.
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