Risk of Colorectal Cancer in Patients With Ulcerative Colitis: A Meta-analysis of Population-Based Cohort Studies
Clinical Gastroenterology and Hepatology , 06/07/2012
Jess T et al. – In population–based cohorts, ulcerative colitis (UC) increases the risk of colorectal cancer (CRC) 2.4–fold. Male sex, young age at diagnosis with UC, and extensive colitis increase the risk.Methods
- The authors used MEDLINE, EMBASE, Cochrane, and CINAHL to perform a systematic literature search.
- They included 8 studies in the meta-analysis on the basis of strict inclusion and exclusion criteria.
- They calculated pooled standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) for risk of CRC in patients with UC and performed meta-regression analyses of the effect of cohort size, calendar period, observation time, percentage with proctitis, and rates of colectomy on the risk of CRC.
- An average of 1.6% of patients with UC was diagnosed with CRC during 14 years of follow-up.
- SIRs ranged from 1.05 to 3.1, with a pooled SIR of 2.4 (95% CI, 2.1-2.7).
- Men with UC had a greater risk of CRC (SIR, 2.6; 95% CI, 2.2-3.0) than women (SIR, 1.9; 95% CI, 1.5-2.3).
- Young age was a risk factor for CRC (SIR, 8.6; 95% CI, 3.8-19.5; although this might have resulted from small numbers), as was extensive colitis (SIR, 4.8; 95% CI, 3.9-5.9).
- In meta-regression analyses, only cohort size was associated with risk of CRC.