S0774 Risk Factors for Colorectal Cancer in Inflammatory Bowel Disease: Observations From a Single Center

Abstract

INTRODUCTION: Inflammatory bowel disease (IBD) imparts a significant risk of colorectal cancer (CRC). Inflammation mediated genetic instability, oxidative stress, altered immune response from inflammatory mediators and effect of intestinal microbiota have been proposed for increased risk of CRC in this population. Publications on factors associated with increased risk of CRC on IBD patients is scarce. The objective of this study was to identify the risk factors associated with CRC in patients with Crohn's disease (CD) and Ulcerative colitis (UC). METHODS: A retrospective study design was used to collect data on baseline demographics, comorbidities, and outcomes in patients with the diagnosis of UC and CD from a single center. Multiple comorbid conditions and use of medications; statins and NSAIDS were reviewed. Multi-variate logistic regression analysis was performed to identify risk factors associated with the diagnosis of colorectal cancer in this patient population. RESULTS: Study sample consisted of 2978 patients; of these 1595 had UC whereas the rest had CD. Mean age for the UC cohort was 57.7 ± 17.6, mean BMI was 28.9 ± 6.8, 54.7% were female. Mean age for CD cohort was 53.0 ± 7.3, mean BMI was 28.3 ± 7.6, 58.2% were female. CRC was diagnosed in 22 patients in CD cohort whereas in the UC cohort, 18 patients were diagnosed with CRC (P = .51). Hypertension, cirrhosis and >10 flares were associated with the diagnosis of CRC in CD (Table 1). Increasing age, female gender, diabetes mellitus and osteoporosis were associated with CRC in UC (Table 2). The predictive capacity of logistic regression models as obtained by receiver operating curves in outlined in Figure 1. CONCLUSION: Patients with IBD have increased risk of CRC than normal population and it is an important cause of mortality in IBD patients. This observational analysis identified varying epidemiologic factors associated with CRC. Interestingly, disease activity as measures by surrogacy of >10 flares was associated with CRC diagnosis in CD cohort but not so in UC cohort. Previous meta-analyses have shown protective effect of statins in UC and CD, which was not seen in our study. Use of NSAIDS was not associated with increased or decreased risk of CRC.Table 1.: Risk factors for CRC in CDTable 2.: Risk factors for CRC in UCFigure 1.: ROC.