Background: Colorectal cancer (CRC) is perhaps the most undesirable adverse outcome in inflammatory bowel disease (IBD). The aim of this study is to estimate the rate of CRC in a single center cohort of IBD patients and to identify potential predisposing factors.
Methods: A retrospective review of the endoscopy charts of the period 1996–2016 was conducted. All patients enrolled exhibited both endoscopic and histologic documentation of IBD.Patient and disease (Montreal classification)characteristics, change in location and behaviour of IBD, location of CRC and treatment with imunomodulators and antiTNFalpha agents were recorded. As index colonoscopy was defined the one that established IBD diagnosis.
Results: 1131 IBD patients having undergone 3584 colonoscopies have been registered. Males are 630 [55.7%]. Median age at IBD diagnosis is 40 years [IQR: 28, range: 2–89]. Median follow-up period is 45.5 months [IQR: 100.4, range: 0–507.5]. Ulcerative colitis (UC) was diagnosed in 614 [54.3%], Crohn's disease (CD) in 507 [44.8%] and IBD unclassified in 10 [0.9%] patients. IBD location changed in 111 UC [18.07%] and in 58 CD [11.44%] patients. CD behaviour progressed to a worse state in 46 [9.07%] patients. Thirteen patients [1.15%] developed CRC; 3 with CD ileocolitis (all in the right colon) and 10 with UC of who 8 were classified as having extensive colitis (four rectal, three in the right and one in the left colon) and 2 as having left-sided colitis (both in the left colon). None of these patients had been operated for IBD. A non-passable colonic stenosis was already known before CRC diagnosis in only one patient while no apparent stenosis had been detected in the rest. Two patients with CRC received azathioprine for more than 3 years, whereas one was treated with infliximab.
Conclusions: The rate of CRC is low in our cohort of IBD patients and compatible with literature data regarding Caucasian populations. No association was observed with specific predisposing factors that were studied.