Inflammatory Bowel Disease and Risk of Colorectal Polyps: A Nationwide Population-Based Cohort Study From Sweden.

IF 8.3 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Journal of Crohns & Colitis Pub Date : 2023-10-20 DOI:10.1093/ecco-jcc/jjad056
Jordan E Axelrad, Ola Olén, Jonas Söderling, Bjorn Roelstraete, Hamed Khalili, Mingyang Song, Adam Faye, Michael Eberhardson, Jonas Halfvarson, Jonas F Ludvigsson
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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 (Crohn's 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.

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炎症性肠病与结直肠息肉的风险:瑞典一项基于全国人群的队列研究。
背景:炎症性肠病(IBD)与结直肠肿瘤的风险增加有关。然而,IBD中特定息肉类型的类型和风险尚不清楚。方法:我们鉴定了41880名患有IBD(克罗恩病[CD:n = 12 850];溃疡性结肠炎 = 29 030])与41880个参考个体相匹配。使用Cox回归,我们计算了由组织病理学代码定义的结直肠肿瘤性息肉[管状、锯齿状/无柄、晚期和绒毛状]的调整后危险比[aHRs]。结果:在随访期间,1648例[3.9%]IBD患者和1143例[2.7%]参考个体发生了肿瘤性结肠息肉,发病率分别为46.1和34.2/10000人年。这与1.23的aHR(95%置信区间[CI]1.12-1.35)相关,无柄锯齿状息肉[8.50,95%CI 1.10-65.90]和传统锯齿状腺瘤[1.72,95%CI 1.02-2.91]的HRs最高。结直肠息肉的aHR在年轻时和诊断后10年被诊断为IBD的患者中尤其升高。UC患结直肠息肉的绝对和相对风险均高于CD[aHRs分别为1.31和1.06],UC和CD的20年累积风险差异分别为4.4%和1.5%,相当于在诊断IBD后的前20年,23名UC患者和67名CD患者中各有一人患上额外息肉。结论:在这项全国性的基于人群的研究中,IBD患者发生肿瘤性结肠息肉的风险增加。IBD的结肠镜监测似乎很重要,尤其是在UC和患病10年后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Crohns & Colitis
Journal of Crohns & Colitis 医学-胃肠肝病学
CiteScore
15.50
自引率
7.50%
发文量
1048
审稿时长
1 months
期刊介绍: Journal of Crohns and Colitis is concerned with the dissemination of knowledge on clinical, basic science and innovative methods related to inflammatory bowel diseases. The journal publishes original articles, review papers, editorials, leading articles, viewpoints, case reports, innovative methods and letters to the editor.
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