Colitis Cancer Research Articles

P0714 Low risk of recurrent or new neoplasia after immunomodulatory therapy in patients with Inflammatory Bowel Disease and previous cancer: a multicentre retrospective Italian study

Abstract Background Whether using immunosuppressors (ISS) or biologics after a diagnosis of cancer in Inflammatory Bowel Disease (IBD) patients (pts) may increase the risk of new or recurrent cancer is undefined. Primary aim: to assess the frequency of new/recurrent cancer in IBD pts treated with ISS and/or biologics after a diagnosis of cancer. Secondary aims: to evaluate in the same population the cancer-related mortality and risk factors for recurrence or new malignancy. Methods In a retrospective multicentre Italian study, clinical records of all IBD pts treated with ISS or biologics after a diagnosis of cancer were reviewed. Inclusion criteria: 1)Diagnosis of Crohn’s Disease(CD) or Ulcerative Colitis(UC); 2)History of cancer; 3)Clinical outcome after cancer ≥6 months (mos). Exclusion criteria: 1)ISS/biologics used for ≤3 mos or ≤3 administrations; 2)missing data. Data expressed as median[range], differences assessed with Student t-test and X-square test, univariate analysis performed to search for risk factors for new or recurrent malignancy. Results Study population included 122 IBD pts(84 CD, 38 UC) treated with ISS/biologics after cancer (Female 58 [47.5%]; age: 59.5[26-89]yrs). Index cancer was: genitourinary in 18(14.8%), non-melanoma skin cancer (NMSC) in 17(13.9%), breast in 15(12.3%), thyroid in 13(10.6%), melanoma in 14(11.4%), colon in 11(9.0%), hematopoietic in 9(7.4%), prostate in 8(6.6%), head-neck and neuro-endocrine each in 4(3.3%), liver in 3(2.5%), other in 3(2.5%), lung in 1(0.8%). ISS used after cancer (duration: 29[4-200] mos) included: thiopurines in 10(37%), methotrexate in 14(51.9%), others in 3(11.1%) pts.Biologics used after cancer (duration: 24[3-180] mos) included: Anti-TNF in 36(32.4%), VDZ in 60(53.6%), UST in 45(40.2%), small molecules in 50(44.6%) and others in 6(5.4%) pts.The median time interval between cancer and ISS or biologics use was 27[0-312] and 48[1-432] mos, respectively. In a median follow up of 8[1-45] yrs after index cancer, 12(9.8%) IBD patients developed new or recurrent malignancy after ISS or biologics use. There were 6 recurrent neoplasms (2 prostatic, 2 thyroid,1 colon,1 melanoma) and 7 new malignancy (6 NMSC,1 Head-neck). No cancer-related death occurred. No differences were observed in terms of IBD phenotype and ISS/biologics treatments between patients with vs without new/recurrent malignancy. At univariate analysis, when considering age at malignancy, smoking habits, gender, IMM treatment and duration before and after index cancer and treatment for malignancy, no predictive factors for new/recurrent malignancy were observed. Conclusion A low frequency of new or recurrent cancer was observed using immunomodulators after cancer in IBD.No risk factors for new/recurrent malignancy were observed.

Molecular Mechanisms and Clinical Aspects of Colitis-Associated Cancer in Ulcerative Colitis

Inflammatory bowel diseases have long been recognized as entities with a higher risk of colorectal cancer. An increasing amount of information has been published regarding ulcerative colitis-associated colorectal cancer and its unique mechanisms in recent decades, as ulcerative colitis constitutes a chronic process characterized by cycles of activity and remission of unpredictable durations and intensities; cumulative genomic alterations occur during active disease and mucosal healing, resulting in a special sequence of events different to the events associated with sporadic colorectal cancer. The recognition of the core differences between sporadic colorectal cancer and colitis-associated cancer is of great importance to understand and guide the directions in which new research could be performed, and how it could be applied to current clinical scenarios. A DSS/AOM murine model has allowed for a better understanding of the pathogenic mechanisms in colitis-associated cancer, as it is currently the closest model to this unique scenario. In this review, we provide a summary of the main molecular mechanisms and the clinical aspects of colitis-associated cancer in ulcerative colitis.

S117 Thyroid Cancer in Inflammatory Bowel Disease

S117 Thyroid Cancer in Inflammatory Bowel Disease

Unveiling the Immune effects of AHR in tumors: a decade of insights from bibliometric analysis (2010–2023)

BackgroundThe Aryl Hydrocarbon Receptor (AHR) is a transcription factor that regulates several biological processes. Its potential in anti-tumor immunotherapy is becoming clearer, yet no bibliometric studies on this topic exist. This study aims to understand the current research landscape and identify future directions through a bibliometric analysis of AHR’s anti-tumor immunological effects.Methods We conducted a comprehensive bibliometric analysis of AHR antitumor immunotherapy papers in the Web of Science Core Collection. Various aspects of the publications were analyzed, and research hotspots and future trends were identified using scientific bibliometric tools and statistical methods.ResultsWe collected 592 English papers published between 2010 and 2023, with an almost annual increase. Most publications were from the USA, followed by China, Germany, and Italy. The journal “Frontiers in Immunology” had the most papers, and the most cited paper was Christiane A. Opitz’s “An endogenous tumour-promoting ligand of the human aryl hydrocarbon receptor.” The research is centered around AHR gene expression, with a growing focus on intestinal disease and the development of Programmed cell death ligand 1 (PD-L1) drugs.ConclusionThis bibliometric study highlights the significance of AHR in immunomodulatory research, outlining the research trends and key contributors. It suggests AHR’s immune effects may mediate the process of colitis cancer transformation, providing valuable insights for future anti-tumor immunotherapy strategies based on AHR.

S2244 Risk of Small Intestine Cancer in Inflammatory Bowel Disease: Results From A Large Multi-Center Database

S2244 Risk of Small Intestine Cancer in Inflammatory Bowel Disease: Results From A Large Multi-Center Database

S1491 Use of Biologics and the Risk of Cancer in Inflammatory Bowel Disease: A Meta-Analysis

S1491 Use of Biologics and the Risk of Cancer in Inflammatory Bowel Disease: A Meta-Analysis

Risk of Small Intestine Cancer in Inflammatory Bowel Disease: A Propensity-Matched Study from a Large Multi-Center Database in the United States.

The risk of small bowel cancer (SBC) in inflammatory bowel disease (IBD) is unclear. We compared the recent trends of SBC in patients with IBD and stratified them based on disease type. We used TriNetX database to access the electronic health records for patients with IBD, ulcerative colitis (UC) and Crohn's disease (CD) from 2005-2024. We used propensity score matching to compare the rate of SBC in patients with IBD, UC, and CD compared to the general population. We adjusted for all known confounders. From 2010-2024, there was an increasing trend of diagnosed SBC in patients with IBD, with an Average Annual Percentage Change (AAPC) of 3.2% (P<0.001). Patients with CD (aHR = 4.83; 95% CI: 3.58 - 6.53; P < .0001) had an increased risk of SBC compared to the general population without IBD, as well as patients with UC (aHR = 2.28; 95% CI: 1.65 - 3.14; P < .0001). The ileum was the most common location across all subgroups. Both patients with CD and, interestingly, UC had an elevated risk for developing SBC compared to the general population.

Preventable Predictive Factors of Post-colonoscopy Colorectal Cancer in Inflammatory Bowel Disease.

Post-colonoscopy colorectal cancer [PCCRC] is a colorectal cancer [CRC] diagnosed after a colonoscopy in which no cancer was detected [index colonoscopy]. Although the overall cumulative rates of PCCRC are low in both the general population and inflammatory bowel disease [IBD] patients, the overall incidence of PCCRC in IBD is greater than that documented in the general population. This study aimed to identify the index colonoscopy-related factors and patients' characteristics influencing IBD-associated PCCRC development. We carried out an observational, retrospective study in which IBD-associated PCCRCs were diagnosed between 2010 and 2023. The PCCRC group was compared with a control cohort of IBD patients without CRC, matched 1:1 by several demographic and clinical features as well as characteristics of index colonoscopy, to minimise selection bias. Among 61 CRCs identified, 37 [61%] were PCCRC. Twelve of the 37 [32%] PCCRC were diagnosed within 12 months after the previous negative colonoscopy, 15 [41%] within 12-36 months, and 10 [27%] within 36-60 months. In the multivariate analysis, the inadequate bowel preparation of the index colonoscopy (odds ratio [OR]: 5.9; 95% confidence interval [CI]: 11.1-31.4) and the presence of high-risk factors for CRC [OR: 24.03; 95% CI: 3.1-187.8] were independently associated with PCCRC. Conversely, prior exposure to immunosuppressors or biologics [OR: 0.17; 95% CI: 0.03-0.83] and random biopsies sampling at index colonoscopy [OR: 0.19; 95% CI: 0.04-0.85] were inversely associated with PCCRC. More than 50% of CRCs in our population were PCCRC. PCCRCs were associated with previous inadequate cleansing and occurred more frequently in high-risk patients.

Past, current, and future trends in the prevalence of primary sclerosing cholangitis and inflammatory bowel disease across England (2015–2027): a nationwide, population-based study

Primary sclerosing cholangitis (PSC) is one of the leading indications for liver transplantation in Europe, and a major risk factor for cancer in inflammatory bowel disease (IBD). However, it is not known how the epidemiology of PSC will change as that of IBD evolves. The aim of this study is to provide nationwide statistics on the past and current prevalence of PSC and IBD across England, and forecast how this is likely to change over time. We accessed and analysed a nationwide population-based administrative healthcare registry, which houses prospectively accrued data since April 1st 2001. In so doing, the past and current prevalence of PSC-IBD and IBD alone was determined among 18-60-year-olds in England, alongside average annual percentage change rates (AAPC), between the 1st of January 2015 and 2020. Past and current prevalence data, alongside trends in incidence and event-free survival rates, were then used to forecast future prevalence between 2021 and2027. In 2015, the prevalence of PSC with prior IBD diagnosis was 5.0 per 100,000 population, rising to 5.7 when including those with IBD diagnosed after PSC. In 2020, prevalence increased to 7.6 (8.6 accounting for IBD developing after PSC), yielding an AAPC of 8.8. In 2027, PSC-IBD prevalence is forecast to be 11.7 (95% prediction interval [PI]: 10.8-12.7), and 13.3 when accounting for IBD developing after PSC (AAPC: 6.4; 95% PI: 5.3-7.5). Comparatively, the prevalence of IBD alone rose among 18-60-year-olds from 384.3 in 2015 to 538.7 in 2020 (AAPC 7.0), and forecast to increase to 742.5 by 2027 (95% PI: 736.4-748.0; AAPC: 4.7, 95% PI: 4.6-4.8). The rate of growth in PSC-IBD is predicted to exceed IBD-alone. Further research is needed to understand changes in disease epidemiology, including aetiological drivers of developing (invariably progressive) liver disease in IBD, and the implications of rising case burden on health care resources. This study was supported by an unrestricted grant provided by Gilead Sciences.

Colorectal Cancer in Inflammatory Bowel Disease: A Review of the Role of Gut Microbiota and Bacterial Biofilms in Disease Pathogenesis.

The risk of colorectal cancer [CRC] is increased in patients with inflammatory bowel disease [IBD], particularly in extensive ulcerative colitis [UC] and Crohn's colitis. Gut microbiota have been implicated in the pathogenesis of CRC via multiple mechanisms, including the release of reactive oxygen species and genotoxins, and induction of inflammation, as well as activation of the immune response. Gut microbiota can enhance their carcinogenic and proinflammatory properties by organising into biofilms, potentially making them more resistant to the host's immune system and to antibiotics. Colonic biofilms have the capacity to invade colonic tissue and accelerate tumorigenesis in tumour-prone models of mice. In the context of IBD, the prevalence of biofilms has been estimated to be up to 95%. Although the relationship between chronic inflammation and molecular mediators that contribute to IBD-associated CRC is well established, the role of gut microbiota and biofilms in this sequence is not fully understood. Because CRC can still arise in the absence of histological inflammation, there is a growing interest in identifying chemopreventive agents against IBD-associated CRC. Commonly used in the treatment of UC, 5-aminosalicylates have antimicrobial and anticarcinogenic properties that might have a role in the chemoprevention of CRC via the inhibition or modulation of carcinogenic gut microbiota and potentially of biofilm formation. Whether biologics and other IBD-targeted therapies can decrease the progression towards dysplasia and CRC, via mechanisms independent of inflammation, is still unknown. Further research is warranted to identify potential new microbial targets in therapy for chemoprevention of dysplasia and CRC in IBD.

Colorectal cancer in inflammatory bowel diseases in St. Petersburg: results of an analytical study

Introduction. Ulcerative colitis (UC) and Crohn’s disease (CD) belong to the category of inflammatory bowel disease (IBD) and are one of the most pressing problems of gastroenterology worldwide, including due to the development of specific life-threatening complications. Chronic inflammation in the colon in IBD is the cause of the development of one of these complications - colorectal cancer, which requires disabling colectomies and is also one of the leading causes of death among IBD patients. In the Russian population of IBD patients the prevalence of dysplasia and cancer of the colon mucosa has not been previously studied in large epidemiological studies. The aim of the study was to assess the incidence of colorectal cancer in patients with IBD in St. Petersburg. Materials and methods. Within the framework of this publication, the results of three studies were compared: a single-center retrospective cohort study conducted on the basis of the city center of IBD in St. Petersburg (516 patients with IBD who admitted to this medical institution for the period 2020-2023); a multicenter epidemiological study aimed at assessing the clinical features of IBD among the population of St. Petersburg (1072 patients with IBD who admitted to 42 outpatient clinics and 6 city hospitals in 2018-2020); registry study based on the general statistical module of the regional IBD Register of St. Petersburg, operating on the basis of a regional fragment of the unified healthcare state information system (12,858 patients with IBD, data collection period: 2019-2022). Results. As a result of comparing data from three studies, the incidence of IBD-associated colorectal cancer in St. Petersburg was calculated, which was 15.7 cases per 10,000 patients with UC per year and 11.5 cases per 10,000 patients with CD per year. Compared to the population of St. Petersburg as a whole, the likelihood of developing colorectal cancer in patients with UC was 2.9 times higher, in patients with CD - 2.4 times higher. At the same time, in a single-center study, when assessing the prevalence of IBD-associated colorectal cancer, it was found that compared with other life-threatening complications of IBD, it was much less common: toxic dilatation of the intestine occurred 3 times more often, intestinal perforation occurred 20 times more often, decompensated bowel stricture occurred 21 times more often, and severe anemia requiring blood transfusion occurred 36 times more common. Also, as a result of a single-center study, it was found that for 1 case of IBD-associated dysplasia of the colon mucosa, there were 5 cases of sporadic dysplasia. Conclusion. The selection of the most effective therapy and systematic endoscopic examination of patients with IBD will significantly reduce the likelihood of developing colorectal cancer, and systematic observation of the patient with regular endoscopic monitoring of the colon with multifocal biopsy will allow timely detection of dysplasia of the colon mucosa in accordance with current clinical guidelines. It can be assumed that within the framework of cancer prevention measures in the first years of follow-up of a patient with IBD from the onset of the disease, it is advisable to give priority to the risk of developing not only IBD-associated dysplasia, but also sporadic dysplasia of the colon mucosa.

MAdCAM-1 targeting strategy can prevent colitic cancer carcinogenesis and progression via suppression of immune cell infiltration and inflammatory signals.

Chronic inflammation caused by infiltrating immune cells can promote colitis-associated dysplasia/colitic cancer in ulcerative colitis (UC) by activating inflammatory cytokine signalling through the IL-6/p-STAT3 and TNFα/NF-κB pathways. Mucosal addressin cell adhesion molecule-1 (MAdCAM-1) expressed on high endothelial venules promotes the migration of immune cells from the bloodstream to the gut via interaction with α4β7 integrin expressed on the immune cells. MAdCAM-1, has therefore drawn interest as a novel therapeutic target for treating active UC. However, the role of MAdCAM-1-positive endothelial cells in immune cell infiltration in dysplasia/colitic cancers remains unclear. We evaluated the expression of MAdCAM-1, CD31 and immune cell markers (CD8, CD68, CD163 and FOXP3) in samples surgically resected from 11 UC patients with dysplasia/colitic cancer and 17 patients with sporadic colorectal cancer (SCRC), using immunohistochemical staining. We used an azoxymethane/dextran sodium sulphate mouse model (AOM/DSS mouse) to evaluate whether dysplasia/colitic cancer could be suppressed with an anti-MAdCAM-1 blocking antibody by preventing immune cell infiltration. The number of MAdCAM-1-positive vessels and infiltrating CD8+ , CD68+ and CD163+ immune cells was significantly higher in dysplasia/colitic cancer than in normal, SCRC and UC mucosa. In AOM/DSS mice, the anti-MAdCAM-1 antibody reduced the number, mean diameter, depth of tumours, Ki67 positivity, number of CD8+ , CD68+ and CD163+ immune cells and the IL-6/p-STAT3 and TNF-α/NF-κB signalling. Our results indicate that targeting MAdCAM-1 is a promising strategy for controlling not only UC severity but also carcinogenesis and tumour progression by regulating inflammation/immune cell infiltration in patients with UC.

Endoscopic Surveillance for Colorectal Cancer in Pediatric Ulcerative Colitis: A Survey Among Dutch Pediatric Gastroenterologists.

This study aimed to evaluate the current clinical practice of Dutch pediatric gastroenterologists regarding the surveillance for colorectal dysplasia and cancer in pediatric ulcerative colitis (UC), including adherence to guidelines, the initiation and interval of surveillance and applied endoscopy techniques. A clinical vignette-based survey was distributed among all 47 pediatric gastroenterologists who are registered and working in the Netherlands. Thirty-three pediatric gastroenterologists treating children with UC, completed the questionnaire (response rate 70%). Of these respondents, 23 (70%) do conduct endoscopic surveillance in their UC patients. Adherence to any of the available guidelines was reported by 82% of respondents. Twenty-four of 31 respondents (77%) indicated the need for development of a new guideline. Profound variation was witnessed concerning the initiation and interval of surveillance, and risk factors taken into consideration, such as disease extent and concomitant diagnosis of primary sclerosing cholangitis (PSC). The available national and European guidelines recommend the use of chromoendoscopy in the performance of surveillance. This technique was conducted by 8% of respondents, whereas 50% conducted conventional endoscopy with random biopsies. The heterogeneity in surveillance practices underlines the need for consistency among the guidelines, explicitly stated by 77% of the respondents. For this, future research on surveillance in pediatric UC is warranted, focusing on the risk of UC-associated colorectal cancer related to risk factors and optimal endoscopy techniques.

Cumulative thiopurine dosing and keratinocyte skin cancer in inflammatory bowel disease: a case-control study.

Patients with inflammatory bowel disease (IBD) treated with thiopurines are at increased risk of keratinocyte skin cancer (KSC). Most international guidelines recommend yearly dermatological screening of thiopurine-treated patients. Whether the association between the development of KSC and the use of thiopurines is dose-dependent remains unclear. The aim of this study was to investigate the association between the cumulative thiopurine dose and KSC development in patients with IBD which can be helpful to assist in further skin cancer risk stratification and personalization of screening recommendations in patients with IBD. We performed a single-center case-control study, including patients with IBD with and without a history of KSC (cases and controls, respectively). The primary outcome was the association of cumulative azathioprine, mercaptopurine and thioguanine dose with KSC development. Univariable and multivariable logistic regression analyses were performed, the latter corrected for age and smoking, known risk factors of KSC. We included 50 cases and 150 controls, predominantly white population. Age and current azathioprine use were univariably significantly associated with KSC development. In multivariable logistic regression analyses, age at inclusion remained significantly associated. Cumulative doses of thiopurines (separate or combined) or duration of thiopurine use did not impact KSC risk, also after correcting for age and smoking. Cumulative thiopurine dose and duration did not show an association with KSC development. Future KSC risk stratification, based on all available KSC risk factors, may aid in selecting individuals who can benefit most from dermatologic screening programs.

Risk of uterine cervical cancer in inflammatory bowel disease: a systematic review and meta-analysis

Background and aims There are limited data on the association between uterine cervical cancer (UCC) and inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC). Methods This systematic review and meta-analysis assessed the risk of UCC in patients with IBD. We searched MEDLINE, Embase, Cochrane Library, Scopus, Web of Science, ClinicalTrials.gov, gray literature and conference proceedings for studies published before 21 January 2022. Two reviewers independently screened studies, extracted data and assessed quality using the Newcastle–Ottawa Scale. Subgroup analyses were based on IBD type, biologic era, immunosuppression status, study location and design, and publication status. Fifteen studies were included. Results The pooled relative risk (RR) of UCC in IBD was 1.34 (95% confidence interval [CI], 1.07–1.69; I 2 = 53.4%). In subgroup analyses, the pooled RRs of UCC in CD and UC were 1.18 (95% CI, 0.97–1.42) and 1.50 (95% CI, 1.01–12.21), respectively. The pooled RRs of UCC in pre-biologic and biologic eras were 1.36 (95% CI, 0.83–2.23) and 1.99 (95% CI, 1.03–3.86), respectively. The pooled RR of UCC in immunomodulator users was 2.18 (95% CI, 0.81–5.87). The pooled RRs of UCC in Asia, Europe and North America were 5.65 (95% CI, 2.65–12.07), 1.13 (95% CI, 0.96–1.34) and 1.38 (95% CI, 1.10–1.73), respectively. Conclusions The risk of UCC was significantly increased in IBD, particularly in UC but not in CD, suggesting that women with IBD should undergo regular UCC screening and consider vaccination.

Extraintestinal Cancers in Inflammatory Bowel Disease: A Literature Review.

Inflammatory bowel disease (IBD) is a group of chronic multifactorial inflammatory disorders including two major entities: Crohn's disease (CD) and ulcerative colitis (UC). Preliminary evidence suggests that patients with IBD may be at increased risk of developing intestinal and extraintestinal cancers (EICs). Actually, little is known about the association between IBD and EICs, and there is ever-growing concern regarding the safety of immunomodulators and biological therapy, which may represent a risk factor for carcinogenesis. The aim of this review is to summarize the evidence regarding the association between IBD and EICs, the safety of immunomodulators and biological therapy and the management of immunomodulators and biologic agents in IBD patients with prior or current EICs. IBD patients have a higher risk of developing different forms of extraintestinal solid organ tumors and hematological malignancies. Immunomodulators and biological therapy may increase the risk of developing some types of EICs and may be consciously used in patients with IBD and current or prior history of malignancy. Decisions regarding the use of immunomodulators or biological therapies should be made on an individual basis, considering a multidisciplinary approach involving oncologists.

Long-term disease course, cost and prognosis of inflammatory bowel disease: epidemiological studies of a European and a Danish inception cohort.

Long-term disease course, cost and prognosis of inflammatory bowel disease: epidemiological studies of a European and a Danish inception cohort.

Multifocal Colorectal Cancer in Ulcerative Colitis Patient - Case Report

Ulcerative colitis (CU) is an inflammatory disease predisposing to colorectal cancer. Colorectal cancer in ulcerative colitis is more often metachronous or synchronous. In this case report we present a patient with multifocal colorectal cancer in the course of CU and operative treatment that was implemented. Additionally primary sclerosing cholangitis was diagnosed in this patient post-operatively.

Risk of Gastric Cancer among Patients with Newly Diagnosed Ulcerative Colitis: A Nationwide Population-Based Study.

Few studies have investigated the risk of gastric cancer (GC) in ulcerative colitis (UC), and the results have been inconsistent. This study aimed to assess the risk of gastric cancer in newly diagnosed UC patients. Based on claims data from Korean National Health Insurance from January 2006 to December 2015, we identified 30,546 patients with UC and randomly selected 88,829 non-UC individuals as controls, who were matched by age and sex. Multivariate Cox proportional hazards regression was used to calculate adjusted hazard ratios (HRs) for gastric cancer events, with covariates taken into account. During the study period, a total of 77 (0.25%) patients with UC and 383 (0.43%) non-UC individuals were diagnosed with GC. After multivariable adjustment, the HR for GC was 0.60 (95% CI: 0.47-0.77) in patients with UC, using non-UC individuals as the reference group. When stratified by age, the adjusted HRs for GC in UC patients were 0.19 (95% CI: 0.04-0.98) for those aged 20-39 years at the time of UC diagnosis, 0.65 (95% CI: 0.45-0.94) for 40-59, and 0.60 (95% CI: 0.49-0.80) for ≥60 as compared to non-UC individuals in the corresponding age groups. When stratified by sex, the adjusted HR for GC was 0.54 (95% CI: 0.41-0.73) in male UC patients of all ages. Within UC patients, a multivariable analysis revealed that the HR for GC was 12.34 (95% CI: 2.23-68.16) for those aged ≥ 60 years at the time of diagnosis of UC. Patients with UC had a decreased GC risk compared with non-UC individuals in South Korea. Within the UC population, advancing age (≥60 years) was identified as a significant risk factor for GC.

Stable Incidence and Risk Factors of Colorectal Cancer in Ulcerative Colitis: A Population-Based Cohort Between 1977–2020

Stable Incidence and Risk Factors of Colorectal Cancer in Ulcerative Colitis: A Population-Based Cohort Between 1977–2020