Long‐term follow‐up reveals high incidence of colorectal cancer in Indian patients with inflammatory bowel disease

Abstract

Background: As the magnitude of sporadic colorectal cancer (CRC) in India is low, magnitude of CRC in ulcerative colitis (UC) is also considered low. As a result, screening for CRC in UC although advocated may not be followed everywhere. We report our data of UC-related CRC from a low-incidence area of sporadic CRC. Methods: A total of 1012 patients with left-sided colitis/pancolitis having more than one full-length colonoscopy performed at least a year after the onset of symptoms were included in retrospective analysis of prospectively maintained case records. In addition, 136 patients with duration of disease >10 years underwent surveillance white-light colonoscopy prospectively during the study period. Results: A total of 1012 individuals were finally included (6542 person-years of follow-up, 68.5% males, disease duration: 6.4 AE 6.8 years). Twenty (1.97%) patients developed CRC. Two (10%) patients developed CRC during the first decade, 10/20 (50%) during the second and 8/20 (40%) after the second decade of disease. The cumulative risk of developing CRC was 1.5%, 7.2% and 23.6% in the first, second and third decade, respectively. Of 136 high-risk UC cases, five (3.6%) had CRC on screening colonoscopy. Disease duration and increasing age of onset were associated with higher risk of CRC. Conclusions: Cumulative risk of CRC in Indian UC patients is as high as 23.6% at 30 years. The risk of CRC increases with increasing age of onset and increasing duration of disease. A low risk of sporadic CRC does not confer a low risk of UCrelated CRC, and regular screening is warranted.

Epidemiology of Inflammatory Bowel Disease in India: The Great Shift East

“…However, these were retrospective studies and included smaller study populations. Recent studies from Mumbai and our centre have reported risk rates which matched those of the West [101,102] . Desai et al [101] from Mumbai reported an incidence density of 3/1,000 in the first 10 years, 3.3/1,000 at 10-20 years, and 7/1,000 at >20 years with an overall prevalence of 2.8%.…”

Elevated red blood cell distribution width contributes to poor prognosis in patients undergoing resection for nonmetastatic rectal cancer

“…[ 25 ] Colorectal cancer can develop from inflammatory bowel diseases and inflammation polys. [ 27 – 29 ] So inflammation might play a crucial role in the development of colorectal cancer. Besides, there also are some articles indicated that inflammation can play dual role in tumorgenesis.…”

The Protection of Crocin Against Ulcerative Colitis and Colorectal Cancer via Suppression of NF-κB-Mediated Inflammation

“…The activation of NF-κB is responsible for the expression of interleukin (IL)-6 ( Qiu et al, 2015 ), which has been recognized as the key promoter in the tumorigenesis of early colitis-associated cancer ( Grivennikov et al, 2009 ). UC patients have a 2.4-fold increased risk of CRC ( Yang et al, 2016 ), and UC-associated CRC constitutes 1% of all CRC cases ( Bopanna et al, 2017 ).…”