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Inflammatory Bowel Disease and Risk of Colorectal Polyps: A Nationwide Population-Based Cohort Study From Sweden
- Publication Year :
- 2023
-
Abstract
- 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.<br />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]
Details
- Database :
- OAIster
- Notes :
- English
- Publication Type :
- Electronic Resource
- Accession number :
- edsoai.on1387005285
- Document Type :
- Electronic Resource
- Full Text :
- https://doi.org/10.1093.ecco-jcc.jjad056