Backwash ileitis is strongly associated with colorectal carcinoma in ulcerative colitis

Heuschen, U.; Hinz, Ulf; Allemeyer, E. H.; Stern, J.; Lucas, Matthias; Autschbach, Frank; Herfarth, Christian; Heuschen, G.

doi:10.1053/gast.2001.22434

Cited by 205 publications

(104 citation statements)

References 45 publications

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“…These data suggest that the presence of terminal ileal inflammation in a left-sided colitis patient should seriously raise the possibility of CD and not UC. The incidence of PSC was significantly higher in BWI+ patients compared to BWI-patients, also confirming the results of prior studies (24,25). Since bile acids are absorbed in the terminal ileum, it is interesting to speculate that the defects in bile acid metabolism noted in PSC patients (26) might account for the relationship between BWI and PSC.…”

Section: Discussionsupporting

confidence: 86%

1104 A Prospective Analysis of Clinical Variables, Serologic Factors and Outcome of Ileal Pouch-Anal Anastomosis in Patients with Backwash Ileitis

White¹,

Dubinsky²,

Melmed³

et al. 2009

Gastroenterology

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Section: Discussionsupporting

confidence: 86%

1104 A Prospective Analysis of Clinical Variables, Serologic Factors and Outcome of Ileal Pouch-Anal Anastomosis in Patients with Backwash Ileitis

White¹,

Dubinsky²,

Melmed³

et al. 2009

Gastroenterology

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“…Important risk factors include primary sclerosing cholangitis (PSC) [25][26][27] , family history of CRC [28] , whereas the role of other factors, such as age at onset of UC, frequency of flare-ups, severity of inflammation [29] , "backwash ileitis" [30] , smoking, medical therapy used (5-aminosalycilates, azathioprine) [31] , is more controversial.…”

Section: Risk Factors For Colorectal Cancer In Ulcerative Colitismentioning

confidence: 99%

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Lakatos¹,

Lakatos²

2008

WJG

368

245

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Since the first report of an inflammatory bowel disease (IBD) case associated with colorectal cancer (CRC) by Crohn and Rosenberg [1] , significant efforts have been made to elucidate this presumed association. Nowadays, the association between IBD and the increased risk for CRC is widely accepted. Although CRC, complicating ulcerative colitis and Crohn's disease, accounts only for 1%-2% of all cases of CRC in the general population, it is considered a serious complication of the disease and accounts for approximately 10%-15% of all deaths in IBD patients [2] . The age at diagnosis of CRC associated with IBD is 15-20 years earlier compared to sporadic cancers. In the meta-analysis by Eaden et al [3] , the average age at diagnosis was 43.2 years. Similarly, in a recent publication from Eastern Europe [4] , it was found to be 50.9 years, 10-15 years younger compared to sporadic CRC cases from the same area (62.2 years) [5] . According to US [6] and Canadian [7] publications, almost two-thirds of the affected patients were males, yet results are conflicting [4,8] . In addition, the frequency of multiple CRCs is higher than in patients with sporadic CRC [9] .The increased risk of CRC in UC is almost a universal finding [3,[10][11][12][13] , yet the extent of this risk varies considerably with differences in study design and geographic area. The initial reports were published by tertiary gastroenterology centers, thus the high risk detected might have been a consequence of referral bias and overinterpretation due to the high percentage of extensive and chronically active cases in these cohorts. Results of population-based studies are more reliable; however, several geographical and ethnic differences have been noted.The report of the meta-analysis by Eaden et al [3] in 2001 was one of several milestones in this subject. The incidence of UC-associated CRC was estimated based on 116 articles involving 54 478 patients in whom 1698 CRC cases were detected. This was a mixture of referral center-based, hospital-based, and population-based studies of variable methodological qualities and levels of detail. The reported incidence was higher in the US AbstractThe risk of colorectal cancer for any patient with ulcerative colitis is known to be elevated, and is estimated to be 2% after 10 years, 8% after 20 years and 18% after 30 years of disease. Risk factors for cancer include extent and duration of ulcerative colitis, primary sclerosing cholangitis, a family history of sporadic colorectal cancer, severity of histologic bowel inflammation, and in some studies, young age at onset of colitis. In this review, the authors discuss recent epidemiological trends and causes for the observed changes. Population-based studies published within the past 5 years suggest that this risk has decreased over time, despite the low frequency of colectomies. The crude annual incidence rate of colorectal cancer in ulcerative colitis ranges from approximately 0.06% to 0.16% with a relative risk of 1.0-2.75. The exact mechanism for this chang...

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“…15 The susceptibility of CD patients to CRC would be 440-fold that of the common population and the onset age would be 10 years earlier. 41 IBD was considered as resulting from the imbalance between luminal bacterial flora and the immune system. 16 Regular use of nonsteroidal anti-inflammatory drugs (NSAID) could reduce the incidence of IBD and CRC.…”

Section: Main Characteristics Of Included Studiesmentioning

confidence: 99%

Relationship between the polymorphism of tumor necrosis factor-α-308 G>A and susceptibility to inflammatory bowel diseases and colorectal cancer: a meta-analysis

Wang

Chen

et al. 2011

Eur J Hum Genet

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Inflammatory bowel disease (IBD) and colorectal cancer (CRC) are common health problems worldwide. Tumor necrosis factor (TNF) is a type of cytokine that induces inflammation and inhibits tumorigenesis. Several studies have assessed the relationship between the polymorphism of TNF-a-308 G4A and the susceptibility to IBD and CRC; however, the results have been controversial. In addition, the hypothesis whether the increased risk of CRC in IBD patients could be partly ascribed to the polymorphism of TNF-a-308 G4A was unclear. Therefore, we conducted this meta-analysis to confirm these associations. Pooled odd ratios (ORs) and 95% confidence intervals (95% CIs) were calculated on the basis of data from 14, 18, and 7 studies from a total of 27 studies for the associations between the polymorphism of TNF-a-308 G4A and ulcerative colitis, Crohn's disease (CD) and CRC. In Europeans, the AA genotype increased the risk of ulcerative colitis (UC) (OR, 2.041; 95% CI, 1.261-3.301) and CD (OR, 1.730; 95% CI, 1.168-2.564) significantly, without obvious heterogeneity and publication bias. Meanwhile, the GA genotype increased the risk of UC in Asians (OR, 2.360; 95% CI, 1.269-4.390) significantly. However, no significant association was observed for CRC in any ethnic population. The results of this meta-analysis suggested that the polymorphism of TNF-a-308 G4A participates in modifying the susceptibility to UC and CD in Europeans and Asians. The increased risk of CRC in IBD patients should be clarified as the combined effects of polymorphisms in TNF-a and other cytokines, and the interaction with environmental factors, in future studies.

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Backwash ileitis is strongly associated with colorectal carcinoma in ulcerative colitis

Cited by 205 publications

References 45 publications

1104 A Prospective Analysis of Clinical Variables, Serologic Factors and Outcome of Ileal Pouch-Anal Anastomosis in Patients with Backwash Ileitis

1104 A Prospective Analysis of Clinical Variables, Serologic Factors and Outcome of Ileal Pouch-Anal Anastomosis in Patients with Backwash Ileitis

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Relationship between the polymorphism of tumor necrosis factor-α-308 G>A and susceptibility to inflammatory bowel diseases and colorectal cancer: a meta-analysis

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