Colorectal Cancer Survival in Patients With or Without Underlying IBD

Dawn O'Shea

October 08, 2020

A study published in the Journal of Crohn's and Colitis has examined whether stage at diagnosis of colorectal cancer (CRC) and survival differ between patients with sporadic cancer, ulcerative colitis (UC) and Crohn's disease (CD).

The study linked data from the English National Cancer Registry, Hospital Episode Statistics and the Office for National Statistics data sets between 2000 and 2010, providing data on comorbidities, stage and date of death.

A total of 234,009 patients with CRC were included, of whom 985 (0.4%) had CD and 1922 (0.8%) had UC.

Analysis revealed that UC, but not CD, was associated with an earlier stage at diagnosis compared with sporadic cancers (OR, 0.88; 95% CI, 0.79-0.98; P=.02). CD had significantly worse survival compared with sporadic patients for stage II (HR, 1.71; 95% CI, 1.26-2.31; P<.005) and stage III (HR, 1.53; 95% CI, 1.20-1.96; P<.005) cancer. UC patients had worse survival compared with the sporadic group for both stage III (HR, 1.38; 95% CI, 1.17-1.63; P<.0005) and stage IV (HR, 1.13; 95% CI, 1.01-1.28; P=.04) cancer.

After excluding sporadic cases, UC was associated with improved survival compared with CD (HR, 0.62; 95% CI 0.43-0.90; P=.01) for stage II cancer.

Despite some limitations, the findings show that patients with CRC and inflammatory bowel disease are diagnosed at an earlier stage but tend to have worse survival compared with sporadic cases of CRC, in particular for nodal disease (stage III). Patients with CD-related CRC appear to fare worst in terms of survival compared with both the sporadic and UC group.

Arhi C, Askari A, Nachiappan S, Bottle A, Arebi N, Athanasiou A, Ziprin P, Aylin P, Faiz O. Stage at diagnosis and survival of colorectal cancer with or without underlying inflammatory bowel disease: a population-based study. J Crohns Colitis. 2020 Sep 29 [Epub ahead of print]. doi: 10.1093/ecco-jcc/jjaa196. PMID: 32991688 View abstract

This article originally appeared on Univadis, part of the Medscape Professional Network.

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