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Older age, IBD duration as risk factors for colitis-associated neoplasia

11 Jan 2019

Among patients with inflammatory bowel disease (IBD), older age at the time of IBD diagnosis and longer disease duration are associated with a heightened risk of developing colitis-associated neoplasia, a study has found.

Researchers looked at 29 adult IBD patients who developed CAN, of whom 69.0 percent had ulcerative colitis and 31.0 percent had Crohn’s disease, and 87 non-CAN controls. They matched the two patient groups according to gender and IBD type. 

In the CAN group, eight patients (27.6 percent) had colorectal cancer (CRC), 20 (69.0 percent) had low-grade dysplasia and one (3.4 percent) had high-grade dysplasia. Compared with controls, CAN patients were older at the time of IBD diagnosis (49.9 vs 36.9 years; p<0.001) and had longer duration of IBD (3.4 vs 2.1 years; p=0.35).

Multivariate logistic regression analysis confirmed that the development of CAN was significantly associated with older age at the time of IBD diagnosis (odds ratio [OR], 1.09; 95 percent CI, 1.04–1.14; p<0.001) and longer IBD disease duration (OR, 1.14; 1.03–1.27; p=0.013).

The observed associations were more pronounced in IBD patients with CRC (age at diagnosis, p=0.012; disease duration, p=0.019) than in those with dysplasia.

These results should be interpreted in light of potential limitations, particularly the retrospective study design, researchers noted. Nevertheless, the data may serve as a springboard for developing a risk-prediction model, which can be applied in daily clinical practice for an individualized approach to CAN surveillance in IBD patients.

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