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Inflammatory Bowel Disease and Risk of Colorectal Polyps: A Nationwide Population-Based Cohort Study From Sweden
NYU, NY USA.
Karolinska Inst, Sweden; Stockholm South Gen Hosp, Sweden; Karolinska Inst, Sweden.
Karolinska Inst, Sweden.
Karolinska Inst, Sweden.
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2023 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 17, no 9, p. 1395-1409Article in journal (Refereed) Published
Abstract [en]

Background: Inflammatory bowel disease [IBD] has been linked to an increased risk of colorectal neoplasia. However, the types and risks of specific polyp types in IBD are less clear. Methods: We identified 41 880 individuals with IBD (Crohns disease [CD: n = 12 850]; ulcerative colitis [UC]: n = 29 030]) from Sweden matched with 41 880 reference individuals. Using Cox regression, we calculated adjusted hazard ratios [aHRs] for neoplastic colorectal polyps [tubular, serrated/sessile, advanced and villous] defined by histopathology codes. Results: During follow-up, 1648 [3.9%] IBD patients and 1143 [2.7%] reference individuals had an incident neoplastic colorectal polyp, corresponding to an incidence rate of 46.1 and 34.2 per 10 000 person-years, respectively. This correlated to an aHR of 1.23 (95% confidence interval [CI] 1.12-1.35) with the highest HRs seen for sessile serrated polyps [8.50, 95% CI 1.10-65.90] and traditional serrated adenomas [1.72, 95% CI 1.02-2.91]. aHRs for colorectal polyps were particularly elevated in those diagnosed with IBD at a young age and at 10 years after diagnosis. Both absolute and relative risks of colorectal polyps were higher in UC than in CD [aHRs 1.31 vs 1.06, respectively], with a 20-year cumulative risk difference of 4.4% in UC and 1.5% in CD, corresponding to one extra polyp in 23 patients with UC and one in 67 CD patients during the first 20 years after IBD diagnosis. Conclusions: In this nationwide population-based study, there was an increased risk of neoplastic colorectal polyps in IBD patients. Colonoscopic surveillance in IBD appears important, especially in UC and after 10 years of disease.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS , 2023. Vol. 17, no 9, p. 1395-1409
Keywords [en]
Crohns disease; ulcerative colitis; polyp; dysplasia; cancer
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-193990DOI: 10.1093/ecco-jcc/jjad056ISI: 000974247400001PubMedID: 36994851OAI: oai:DiVA.org:liu-193990DiVA, id: diva2:1758578
Note

Funding Agencies|Crohns and Colitis Foundation; Judith & Stewart Colton Center for Autoimmunity; NIH NIDDK Diseases [K23DK124570]; Swedish Research Council [2020-02002]; Young Scholar Award from the Strategic Research Area Epidemiology Program at Karolinska Institutet; Stockholm County Council [ALF]; Karolinska Institutet [ALF]; FORTE Foundation; Swedish Cancer Foundation; American College of Gastroenterology Senior Research Award; Beker Foundation; American Cancer Society Mentored Research Scholar Grant; NIH [R00CA215314, U01CA261961]

Available from: 2023-05-23 Created: 2023-05-23 Last updated: 2024-03-26Bibliographically approved

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Division of Diagnostics and Specialist MedicineFaculty of Medicine and Health SciencesMag- tarmmedicinska kliniken
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