Gastrointestinal neoplasia in patients with inflammatory bowel disease: Opportunities to enhance preventative strategies

Young, Edward J.; Lawrence, Matthew; Thomas, Michelle; Andrews, Jane M.

doi:10.1002/jgh3.12193

Cited by 2 publications

(1 citation statement)

References 17 publications

(21 reference statements)

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“…We previously reported a retrospective case series 14 including all patients with colorectal adenocarcinoma, high‐grade dysplasia (HGD) or multifocal low‐grade dysplasia (LGD) within IBD‐affected mucosa in a single tertiary centre between 2007 and 2017. As expected, these patients had multiple indicators of significant cumulative burden of inflammation, however this case series also highlighted apparently novel risk factors for GI adenocarcinoma including poor engagement in care, non‐adherence with medications and mental health comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Poor engagement and adherence predict neoplasia in inflammatory bowel disease: a case‐control study

Young

Jones

Thomas

et al. 2022

Internal Medicine Journal

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Background Colorectal adenocarcinoma is an important and preventable complication of inflammatory bowel disease (IBD). A previous case series suggested mental health issues and poor engagement in care as novel risk factors. Aims To confirm the role of patient engagement in care in the development of neoplasia using a case‐control methodology. Methods Patients in a single referral centre from 2007 to 2017 with colorectal adenocarcinoma, high‐grade dysplasia or multifocal low‐grade dysplasia were included as neoplasia cases. Each case was assigned up to three matched controls (matched for age, gender, underlying disease, IBD type and phenotype and disease duration). Novel and known risk factors were compared between groups. Results Thirty‐two cases with 88 matched controls were included. Patients with neoplasia were more likely to have poor adherence to, or engagement with, care (odds ratio (OR) 4.79). They were also more likely to have chronic use of opioids (OR 3.86) and long‐term prednisolone (OR 2.97). Of note, no difference was found in measures of socioeconomic disadvantage, reflecting equitable access to healthcare in the public institution where the care was studied. As previously shown, patients with neoplasia had multiple markers of increased cumulative burden of inflammation, including more IBD‐related hospital admissions, elevated inflammatory markers and severe inflammation at colonoscopy. Conclusions This study confirms poor adherence or engagement with care as a new risk factor for colorectal adenocarcinoma in patients with IBD; identifying a vulnerable group whom clinicians should endeavour to engage in order to avoid this catastrophic complication.

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Section: Introductionmentioning

confidence: 99%

Poor engagement and adherence predict neoplasia in inflammatory bowel disease: a case‐control study

Young

Jones

Thomas

et al. 2022

Internal Medicine Journal

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Psychiatric Disorders in Adult and Paediatric Patients With Inflammatory Bowel Diseases – A Systematic Review and Meta-Analysis

Arp

Jansson

Wewer

et al. 2022

Journal of Crohn's and Colitis

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Background Inflammatory bowel diseases (IBD), which are associated with a high disease burden, are also reported to be accompanied by a high prevalence of psychiatric disorders. However, the literature on IBD and psychiatric disorders has not been reviewed. Methods This systematic review followed the PRISMA guidelines, and its protocol was registered at PROSPERO (ID: CRD42020214359). PubMed, Embase and PsycINFO were consulted for the literature search. Studies reporting on diagnosed psychiatric disorders in IBD were included. Pooled prevalence rates were calculated using random effects meta-analyses. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Results Sixty-nine studies were identified with an average cohort size of 60,114 patients. Pooled prevalence rates were: mood disorders, 10% (95% CI=7%; 15%); anxiety disorders, 12% (95% CI=8%; 18%); substance misuse, 3% (95% CI=1%; 7%); psychotic disorders, 2% (95% CI=1%; 4%); behavioral disorders, 1% (95% CI=0%; 3%); personality disorders, 3% (95% CI=1%; 10%); developmental disorders, 1% (95% CI=0%; 3%); behavioral and emotional disorders with onset usually during childhood, 1% (95% CI=1%; 3%). All analyses had high statistical heterogeneity (I2 > 99%). Seven studies reported an increased risk of suicide in IBD patients compared to controls. Conclusion The prevalence of psychiatric comorbidities was high (11- 82%) in patients with IBD and was higher than in the background population. Addressing mental health problems in patients with IBD can improve their adherence to treatment and the somatic disease course and, consequently, reduce morbidity and mortality.

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Gastrointestinal neoplasia in patients with inflammatory bowel disease: Opportunities to enhance preventative strategies

Cited by 2 publications

References 17 publications

Poor engagement and adherence predict neoplasia in inflammatory bowel disease: a case‐control study

Poor engagement and adherence predict neoplasia in inflammatory bowel disease: a case‐control study

Psychiatric Disorders in Adult and Paediatric Patients With Inflammatory Bowel Diseases – A Systematic Review and Meta-Analysis

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