Abstract
Background & aimsInflammatory bowel diseases (IBD) and cholecystectomy are associated with the risk of colorectal cancer (CRC). Our aim was to determine the association between cholecystectomy and the CRC risk in IBD.MethodsWe first obtained the Taiwan National Health Insurance Research Database (NHRID), which contains information on approximately 24.7 million insured individuals. A cohort study was conducted using the data from the NHIRD, and included cohort patients with IBD who had experienced a cholecystectomy between the years 1998 and 2010. The non-cholecystectomy cohort comprised the remaining IBD patients who had not undergone a cholecystectomy. Multivariate Cox proportional hazard regression analysis was used to determine the effects cholecystectomy have on the risks of developing CRC, as shown by Hazard Ratios (HRs) with 95% confidence intervals (CIs).ResultsThe incidence rate of CRC among IBD patients who had undergone a cholecystectomy (n = 525) was 1.75 per 1,000 person-years, compared to 1.41 per 1,000 person-years among IBD patients who had not had a cholecystectomy (n = 525). The adjusted HRs for CRC was found to be 0.76 (95% CI 0.25–2.32) for IBD patients having received a cholecystectomy, after adjusting for age, gender, and comorbidities. By type of IBD, neither ulcerative colitis nor Crohn’s diseases are associated with CRC after a cholecystectomy adjusted HR (2.78 [95% CI 0.54–14.3]) and (0.13 [95% CI 0.01–1.49]).ConclusionIn Taiwan, cholecystectomies are not associated with a risk of CRC in patients with IBD.
Highlights
The adjusted Hazard Ratios (HRs) for colorectal cancer (CRC) was found to be 0.76 for inflammatory bowel disease (IBD) patients having received a cholecystectomy, after adjusting for age, gender, and comorbidities
By type of IBD, neither ulcerative colitis nor Crohn’s diseases are associated with CRC after a cholecystectomy adjusted HR (2.78 [95% confidence intervals (CIs) 0.54–14.3]) and (0.13 [95% CI 0.01–1.49])
In Taiwan, cholecystectomies are not associated with a risk of CRC in patients with IBD
Summary
A recent systemic analysis has concluded that colorectal cancer (CRC) remains a problem in patients with inflammatory bowel disease (IBD). [1] Time-trend studies demonstrated a decreasing risk of CRC in ulcerative colitis patients. [2] Cholecystectomy is considered a risk associated with developing intestinal cancers, including CRC.[3,4,5,6,7] By location, this positive association is strictly for colon cancer, and not for rectal cancer. [4] Cholecystectomy in recurrent adenomas and multiple advanced recurrent adenomas are considered to present a slightly increased risk of CRC. [5] some studies failed to demonstrate an association between cholecystectomy and intestinal cancers. [8,9] performing a cholecystectomy via laparoscopy or other surgical technique has not yet been investigated for carrying different risks for CRC.The risk of CRC after a cholecystectomy has been defined in several studies for the general population.[3,4,5,7,10] The risk of intestinal cancers declines with the increase of distance from the common bile duct after a cholecystectomy. [2] Cholecystectomy is considered a risk associated with developing intestinal cancers, including CRC.[3,4,5,6,7] By location, this positive association is strictly for colon cancer, and not for rectal cancer. [4] Cholecystectomy in recurrent adenomas and multiple advanced recurrent adenomas are considered to present a slightly increased risk of CRC. [5] some studies failed to demonstrate an association between cholecystectomy and intestinal cancers. No study has investigated whether cholecystectomy alter the risk of CRC. This study aimed to evaluate the risk of CRC after a cholecystectomy in patients with IBD using claims data obtained from the National Health Insurance (NHI) program of Taiwan
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