Primary sclerosing cholangitis and the risk of colon neoplasia in patients with Crohn's colitis

Gastroenterology Report
Udayakumar NavaneethanRavi P Kiran

Abstract

Crohn's colitis (CC) is associated with primary sclerosing cholangitis (PSC). However the risk of colon cancer or dysplasia in CC and PSC is unclear. Our aim was to study the risk of colon neoplasia in CC in patients with and without PSC. This is a nested, case-control cohort study of all patients diagnosed with concurrent CC and PSC, seen at the Cleveland Clinic between 1985 and 2012. Forty-three patients with both CC and PSC were compared with a random sample of 159 CC controls without PSC during the same period. Seven (16.3%) of 43 CC patients with PSC developed colon cancer or dysplasia, compared with 22 (13.8%) of 159 controls (P = 0.98). Of seven colon neoplasia cases in the PSC group, 100% occurred proximal to the splenic flexure, compared with 50% (11/22) cases of colon neoplasia in controls occurring in the proximal colon (P = 0.001). Based on Cox regression analysis, male gender independently increased the risk of neoplasia [hazard ratio (HR) = 2.68; 95% confidence interval (CI) 1.30-5.54; P = 0.008], as did age at CC diagnosis (HR = 1.29; 95% CI 1.14-1.47; P < 0.001), while the use of azathioprine/6-mercaptopurine was protective (HR = 0.30; 95% CI 0.13-0.70; P = 0.005). The presence of PSC did not increase the risk f...Continue Reading

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Nov 4, 2016·Scandinavian Journal of Gastroenterology·Sonja BoydMartti A Färkkilä
May 6, 2017·Expert Review of Gastroenterology & Hepatology·Samba Siva Reddy Pulusu, Ian C Lawrance
Mar 27, 2018·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Cyriel Y PonsioenLara Dimick-Santos

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