- Patients with Crohn's disease are at greater risk for colorectal cancer (CRC) diagnosis and CRC mortality.
Why this matters
- The study updates risk in the context of changes in diagnostic workup for Crohn's disease, CRC surveillance, and Crohn's and CRC treatment.
- A nationwide cohort study in Denmark and Sweden (1969-2017; n=47,035 with Crohn's disease; n=463,187 reference individuals).
- Funding: Various nonindustry sources.
- More CRC deaths in the Crohn's disease cohort than among control individuals:
- 0.47 vs 0.31 per 1000 person-years.
- aHR, 1.74 (95% CI, 1.54-1.96).
- More CRC diagnoses in the Crohn's disease cohort than among control individuals:
- 0.82 vs 0.64 per 1000 person-years.
- aHR, 1.40 (95% CI, 1.27-1.53).
- Among those diagnosed with CRC, those with comorbid Crohn's disease were at greater risk for CRC mortality:
- aHR, 1.42 (95% CI, 1.16-1.75).
- Among patients with Crohn's disease eligible for CRC surveillance according to current guidelines, the risk for CRC was higher among those:
- Diagnosed with Crohn's before age 40 years.
- With disease activity only in the colon.
- With primary sclerosing cholangitis.
- Death certificates may have attributed death to CRC more often in patients with Crohn's disease than in reference patients.