Prevalence Of Colorectal Cancer In Patients Research Articles

Exploring the Association between Benign Anorectal Conditions and Colorectal Cancer from the Analysis of Lower Gastrointestinal Endoscopies

Abstract Objective Patients experiencing hemorrhoids or fissures may overlook other gastrointestinal (GI) symptoms, assuming that they are linked solely to their existing condition. However, colon cancer, often asymptomatic, can coincide with benign pathologies detected during colonoscopy. This study investigates the prevalence of colorectal cancer (CRC) in patients undergoing lower GI endoscopy for hemorrhoids and elucidates the correlation between cancer and benign pathologies identified during colonoscopy. Highlighting its potential to reveal hidden cancers emphasizes the critical role of colonoscopy in comprehensive health care. Methods The primary objective was to thoroughly investigate the prevalence of CRC in patients who underwent lower GI endoscopy for hemorrhoids. A comprehensive analysis was conducted using a dataset spanning 7 years of lower GI endoscopy. The main focus of this investigation was to determine the incidence of cancer. Additionally, a meticulous examination of accompanying benign diagnoses was performed to provide a comprehensive evaluation. Results The study cohort, comprising 6,268 patients, revealed a noteworthy coexistence of malignancies with common conditions. The revelation was of paramount significance that the total number of malignant cases within this cohort was 440. Polyps emerged as the most frequently observed condition, constituting 55.2% (n = 243) of the cases. Diverticulosis was present in 6.6% (n: 29) of cases, while ulcerative colitis was detected in 8% (n: 2) of cases. Hemorrhoids were identified in 20.7% (n: 91) of cases. The findings indicated a substantial association between these common conditions and malignancy. Specifically, it was discovered that approximately 1 in 22 individuals with hemorrhoids, 1 in 52 individuals with fissures, and 1 in 5.7 individuals with polyps were diagnosed with malignancy. Conclusion This study highlights the pivotal role of colonoscopy in uncovering hidden cancers, especially in patients with hemorrhoids. The findings emphasize the significance of doctors and patients prioritizing colonoscopy, as it allows for early detection and intervention for potential malignancies, even in the presence of hemorrhoids.

Prevalence of irritable bowel syndrome and its association with colorectal cancer: a systematic review and meta-analysis.

This study evaluates the risk of colorectal cancer (CRC) in patients with Irritable Bowel Syndrome (IBS). A literature search was performed on MEDLINE, EMBASE, SCOPUS, and Google Scholar from inception to 31st January 2020 without any limitations on article type or language for studies reporting data on CRC on patients with IBS. A meta-analysis was performed to estimate the prevalence of CRC among patients with IBS. Data extraction was according to the PRISMA guidelines. The quality of the included studies was assessed according to the Newcastle Ottawa Scale. Twenty-one articles were eligible for data extraction and quantitative analysis. Of them, 11 were included in the meta-analysis (IBS n=284 366, no-IBS n=8 390 509). The pooled prevalence of CRC in patients with IBS was 0.96% (95% CI-0.184%-2.344%). The prevalence was lowest in the constipation-predominant IBS (pooled prevalence 1.126%. Patients with IBS-D and IBS-U had an equal pooled prevalence of CRC (2.49%). Eleven studies compared the prevalence of CRC in patients with IBS with a control population. The pooled OR was 2.8 (CI 2.305-3.294). There was an increased risk of CRC among patients diagnosed with IBS, primarily in the first year after IBS diagnosis. The review was registered on PROSPERO (CRD42021236707).

311 Colorectal Neoplasm in Patients With Cryptogenic Pyogenic Liver Abscess, Do They Need Routine Screening Colonoscopy: A Systematic Review and Meta-Analysis

INTRODUCTION: Patients with cryptogenic pyogenic liver abscess (PLA) do not have a definite source of infection and it could be a manifestation of compromised colonic mucosal barrier due to colorectal cancer (CRC). Association of PLA and CRC is unclear. Evidence is weak and limited to small sized studies. As a result, the need for screening colonoscopy in PLA patients is subject to debate and currently not established. METHODS: We conducted a comprehensive search of multiple electronic databases and conference proceedings (from inception through January 2019) to identify studies that reported on the prevalence of CRC in PLA patients. Our goal was to evaluate the pooled rate of prevalence of CRC in patients with cryptogenic PLA. Heterogeneity was measured by I2 statistics and funnel-plot was used to assess publication bias. RESULTS: 12 studies were included in the analysis. Majority of them were from East Asian countries. 18,607 patients were diagnosed with PLA in study group and 60,130 patients were in control group. 63% were males in the age range of 56 to 94 years. 90.5% of the lesions were left sided and 93.1% were positive for Klebsiella pneumoniae. A total of 18,607 PLA patients were reported, of which 17,906 patients underwent screening colonoscopy. A total of 713 colorectal lesions were found, of which 648 were diagnosed with CRC. 60,130 patients were used as control, of which 509 patients were diagnosed with CRC. The pooled rate of prevalence of CRC was 7.9% (95% CI 5-12.1, I2 = 92.4, relative risk = 6.6) in patients with PLA, as compared to 1.2% (95% CI 0.3-5.7, I2 = 93.4) in control, with statistical significance (P = 0.001). Relative risk = 6.6. Publication bias was present. CONCLUSION: In conclusion, our meta-analysis demonstrates that patients with cryptogenic PLA have a 7-fold risk of having CRC, when compared to people without PLA. Although limited by heterogeneity, our results support the need for a screening colonoscopy in patients diagnosed with cryptogenic PLA, especially if positive for Klebsiella pneumoniae.

127 The Epidemiology of Colorectal Cancer in Chronic Kidney Disease in the U.S.: A Population-Based Study (2014–2019)

INTRODUCTION: Recent studies have shown an association between chronic kidney disease (CKD) and increased risk of developing cancer. Limited data is available regarding the prevalence of colorectal cancer (CRC) in patients with CKD. Using a large database, we sought to evaluate this potential risk association. METHODS: We reviewed data from a commercial database (Explorys Inc, Cleveland, OH, USA) that provided electronic health records from 26 major integrated US healthcare systems. Based on the Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT), we identified a cohort of patients with a diagnosis of CRC without CKD, from 2014–2019, which served as a control group. Similarly, we identified a cohort of patients with SNOMED-CT diagnosis of first ever with CRC after at least one year of CKD diagnosis. We performed analyses to describe distributions based on age, gender, and race, as well as to evaluate underlying risk factors. RESULTS: Of the 36,770,450 individuals in the database (2014–2019), 1,359,450 had the diagnosis of CKD (3.69%) and 1,438,540 (3.91%) had the diagnosis of CRC. Amongst CKD patients, 73520 (5.4%) individuals had a first ever diagnosis of CRC after at least one year of being diagnosed with CKD. When compared to individuals without a history of CKD, CKD patients were more likely to develop CRC [OR: 1.76; 95% CI 1.74–1.77, P < 0.0001]. Individuals with CKD and CRC were more likely to be males [OR: 1.21; 95% CI 1.19 to 1.23, P < 0.0001], elderly (age >65) [OR: 3.62; 95% CI 3.55 to 3.69, P < 0.0001], and African American [OR: 2.34; 95% CI 2.30 to 2.38, P < 0.0001]. They were also more likely to be smokers [OR: 1.38; 95% CI 1.36 to 1.41, P < 0.0001], diabetic [OR: 5.04; 95% CI = 4.96 to 5.11, P < 0.0001], and with history of IBD [OR: 1.32; 95% CI 1.27 to 1.38, P < 0.0001], obesity [OR: 2.55; 95% CI 2.49 to 2.56, P < 0.0001] and exposure to radiation [OR: 1.14; 95% CI 1.09 to 1.19, P < 0.0001] when compared to individuals without CKD (Figure 1). CONCLUSION: This population-based cohort study indicated a possible increase of 19.2% in the prevalence of CRC in patients with CKD compared to those without CKD. This may be due to either an increased utilization of the health care system by CKD patients or another unknown confounding factor or even a true association. Given the limitations of our study due to the risk of confounding bias in the database and lack of endoscopic and histological data, this association needs to be confirmed in further studies.

Systematic review with meta‐analysis: the declining risk of colorectal cancer in ulcerative colitis

Patients with ulcerative colitis (UC) have an increased risk of developing colorectal cancer (CRC); however, the magnitude of this effect is open to debate. To assess the risk of CRC in UC patients by systematic review and meta-analysis. A systematic literature search was performed up to November 2013. We selected studies describing the incidence and prevalence of CRC in patients with UC. Articles were assessed for quality using the Newcastle-Ottawa Scale. Cumulative incidence and incidence rates of CRC were combined and analysed using the generic inverse variance method. Sub-analyses were performed to identify factors associated with an increased risk of developing CRC. A total of 81 studies (181 923 patients) met the inclusion criteria. The incidence rate of CRC in patients with UC was 1.58 per 1000 patient-years (py) [95% confidence interval (CI), 1.39–1.76]. Results were heterogeneous (I2 = 81–89%). The incidence rate was 4.02/1000 py (95%CI = 2.74–5.31) in studies that only included patients with extensive colitis, and 1.24/1000 py (95%CI = 1.01–1.47) in population-based studies. The incidence rate was 0.91/1000 py (95%CI = 0.61–1.2) in the first decade of disease, 4.07/1000 py (95%CI = 2.58–5.56) in the second, and 4.55/1000 py (95%CI = 2.64–6.46) in the third. The incidence rate decreased from 4.29/1000 py in the studies published in the 1950s to 1.21/1000 py in studies published in the last decade. The risk of patients with ulcerative colitis developing colorectal cancer has decreased steadily over the last six decades, but the extent and duration of the disease increase this risk.

PWE-153 Association Between Constipation and Colorectal Cancer: Systematic Review and Meta-Analysis of Observational Studies

IntroductionConstipation is common in the community, and may affect survival adversely. An association between constipation and development of colorectal cancer (CRC) could be one possible explanation for this association. We...

Association Between Constipation and Colorectal Cancer: Systematic Review and Meta-Analysis of Observational Studies

Constipation is common in the community, and may affect survival adversely. An association between constipation and development of colorectal cancer (CRC) could be one possible explanation. We performed a systematic review and meta-analysis examining this issue. We searched MEDLINE, EMBASE, and EMBASE Classic (through July 2012). Eligible studies were cross-sectional surveys, cohort studies, or case-control studies reporting the association between constipation and CRC. For cross-sectional surveys and cohort studies, we recorded number of subjects with CRC according to the constipation status, and for case-control studies, number of subjects with constipation according to CRC status were recorded. Study quality was assessed according to published criteria. Data were pooled using a random effects model, and the association between CRC and constipation was summarized using an odds ratio (OR) with a 95% confidence interval (CI). The search strategy identified 2,282 citations, of which 28 were eligible. In eight cross-sectional surveys, presence of constipation as the primary indication for colonoscopy was associated with a lower prevalence of CRC (OR=0.56; 95% CI 0.36-0.89). There was a trend toward a reduction in odds of CRC in constipation in three cohort studies (OR=0.80; 95% CI 0.61-1.04). The prevalence of constipation in CRC was significantly higher than in controls without CRC in 17 case-control studies (OR=1.68; 95% CI 1.29-2.18), but with significant heterogeneity, and possible publication bias. Prospective cross-sectional surveys and cohort studies demonstrate no increase in prevalence of CRC in patients or individuals with constipation. The significant association observed in case-control studies may relate to recall bias.

Incidence and risk factors for developing colorectal cancer in ulcerative colitis: analysis of 401 patients

Background and Aim: Colorectal cancer (CRC) is the most feared long-term complication in patients with ulcerative colitis (UC). The prevalence of CRC in patients affected by UC is 3.7%. As a referral centre, we retrospectively analysed patients who underwent surgery for UC with the aim of identifying the risk factors for developing CRC and its incidence.

Trends of ulcerative colitis‐associated colorectal cancer in Korea: A KASID study

The number of patients with ulcerative colitis (UC) in Korea has increased. In addition, the number of patients with colorectal cancer (CRC) associated with UC has also increased. Therefore, this population-based nationwide study was conducted to investigate the incidence of CRC in patients with UC in Korea and compare these results to those of studies conducted in other countries. The Korean Association for the Study of Intestinal Diseases (KASID) reviewed 7061 cases of UC that occurred between 1970 and 2005 and found a total of 26 cases of CRC. The overall prevalence of CRC in patients with UC was 0.37%. In addition, the estimated cumulative risk of UC-associated CRCs was 0.7% for patients that had UC for 10 years, 7.9% for patients that had UC for 20 years, and 33.2% for patients that had UC for 30 years. The mean age at the time of diagnosis with CRC was 49.6 years, and the mean duration of UC prior to the development of CRC was 11.5 years. Most UC-associated CRCs were diagnosed after they were already in advanced stages; however, the stage at diagnosis was lower in patients that had good compliance with medical treatment. The cumulative incidence of UC-associated CRCs in Korea was found to be comparable to that of western countries. The overall occurrence of UC-associated CRC in Korea may be growing, therefore, intensive surveillance colonoscopy and constructive chemoprevention should be encouraged to enable early detection and treatment of UC-associated CRCs in Korea.

SERUM FERRITIN ACCURATELY PREDICTS NEED FOR COLONOSCOPY IN PATIENTS WITH ANEMIA

Purpose: Evaluate the prevalence of colorectal cancer (CRC) in patients with anemia and ferritin of <50 ng/ml (low), 50 to 100 ng/ml (low normal), >100 ng/ml (normal) and compare that to a control group of non-anemic persons undergoing screening colonoscopy. Methods: The computerized endoscopy database at a VA medical center was searched from 1997 to 2003. All patients undergoing colonoscopy for evaluation of anemia were identified. Patients with overt or occult GI bleeding, h/o GI pathology (including polyps) or family h/o colon cancer were excluded. Medical charts were reviewed and data collected. A priori, subjects were stratified by serum ferritin: <50 ng/ml, 50–100 ng/ml and >100 ng/ml. Controls were defined as a-symptomatic, non-anemic patients undergoing screening colonoscopy. The prevalence of CRC was determined in each group. Results were compared using t tests and contingency table analysis with Fischer's exact test. Results: 414 case subjects and 323 controls met inclusion criteria. 97% of subjects were male, 96% were white with average age of 70 years. 94% of controls were male, 99% were while with average age of 66 years. The prevalence of CRC in patients with ferritin <50 ng/ml, 50–100 ng/ml, >100 ng/ml and controls was 5.9% (15/254), 2.2% (1/45), 0.86% (1/115) and 0.6% (2/323) respectively. The ODDS RATIO for CRC in the above groups was 9.8, 7.6, 1.4 and 1.0 respectively. There was a statistically significant difference between prevalence of CRC in patients with ferritin <50 ng/ml and ferritin >100 ng/ml (p = 0.02) or controls (p = 0.005). There was no significant difference between patients with ferritin <50 ng/ml and ferritin 50–100 ng/ml (p = 0.48) or between ferritin >100 ng/ml and controls (p = 0.55). Conclusions: Borderline IDA (ferritin 51–100 ng/ml) should be treated with the same degree of concern as IDA. Patients with anemia and serum ferritin >100 ng/ml do not have increased prevalence of CRC. Age appropriate CRC screening is adequate evaluation for this group.Figure 1