The Risk of Colorectal Cancer in Patients with Ulcerative Colitis

Nowacki, Tobias M.; Brückner, Markus; Eveslage, Maria; Tepasse, P; Pott, Friederike; Thoennissen, Nils H.; Hengst, K; Ross, Matthias; Bettenworth, Dominik

doi:10.1007/s10620-014-3373-2

Cited by 36 publications

(38 citation statements)

References 44 publications

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“…Three [7, 8, 22] of the 17 studies were population-based studies and showed that 5-ASA exhibited protective effects against the risk of CRC/Dys (OR population-based = 0.23, 95% CI: 0.09–0.60, I 2 = 52.5%, P = 0.122) (Figure 4). The remaining fourteen clinical-based studies [10–13, 20, 21, 31–33, 35–37, 39, 40] also showed a pooled beneficial effect of 5-ASA on the risk of CRC/Dys (OR clinical-based = 0.52, 95% CI: 0.39–0.68, I 2 = 20.6%, P = 0.230) (Figure 4). Nine of the 17 studies used CRC as an outcome [7, 8, 10, 11, 20–22, 32, 40], revealing a protective effect of 5-ASA on CRC risk (OR CRC = 0.40, 95% CI: 0.30–0.55, I 2 = 23.3%, P = 0.237).…”

Section: Resultsmentioning

confidence: 96%

“…Dys and CRC are different pathological stages in the development of colonic carcinoma. Some studies [7–11, 15–17, 20–22, 32, 34, 38, 40] reported only the outcome of CRC, some [35, 41] reported only the outcome of Dys, while others [12–14, 19, 31, 33, 36, 37, 39] reported the combined outcome (CRC/Dys). In this meta-analysis, we further divided the studies into three subgroups according to the different reported outcomes (CRC, Dys, and CRC/Dys).…”

Section: Resultsmentioning

confidence: 99%

“…Twelve [7–9, 11, 13, 16, 19, 20, 22, 32, 33, 41] of the 26 studies were conducted in Europe, nine [10, 12, 15, 29, 31, 34, 36–38] were conducted in North America, four [21, 35, 39, 40] were conducted in Asia, and one [14] was conducted in both Europe and North America. The chemo-preventive effect of 5-ASA was exhibited in the studies conducted in Asia (OR Asia = 0.25, 95% CI: 0.14–0.47, I 2 = 0.0%, P = 0.962) and Europe (OR Europe = 0.55, 95% CI: 0.42–0.73, I 2 = 30.9%, P = 0.144).…”

Section: Resultsmentioning

confidence: 99%

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Chemopreventive effects of 5-aminosalicylic acid on inflammatory bowel disease-associated colorectal cancer and dysplasia: a systematic review with meta-analysis

Qiu

Wang

et al. 2016

Oncotarget

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Background and AimsThe chemopreventive effect of 5-aminosalicylic acid (5-ASA) in patients with inflammatory bowel disease (IBD) has been widely studied; however, the results remain conflicting. The aim of this study was to systematically review the literature and update evidence concerning effects of 5-ASA on the risk of colorectal cancer (CRC) and dysplasia (Dys) in patients with ulcerative colitis (UC) or Crohn's disease (CD).Results5-ASA showed a chemopreventive effect against CRC/Dys in IBD patients (OR = 0.58, 95% CI: 0.45−0.75). However, this effect was significant only in clinical-based studies (OR = 0.51; 95% CI: 0.39−0.65), but not in population-based studies (OR = 0.71; 95% CI: 0.46−1.09). Moreover, this effect was noticeable in patients with UC (OR = 0.46, 95% CI: 0.34−0.61), but not in CD (OR = 0.66, 95% CI: 0.42−1.03), and on the outcome of CRC (OR = 0.54, 95% CI: 0.39−0.74), but not Dys (OR = 0.47; 95% CI: 0.20−1.10). In IBD patients, mesalazine dosage ≥ 1.2 g/day showed greater protective effects against CRC/Dys than dosages < 1.2 g/day. However, Sulphasalazine therapy did not show any noticeable protective function regardless of the dosage administered.Materials and MethodsWe performed a systematic review with a meta-analysis of 26 observational studies involving 15,460 subjects to evaluate the risks of developing CRC and Dys in IBD patients receiving 5-ASA treatment. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each evaluation index.Conclusions5-ASA has a chemopreventive effect on CRC (but not Dys) in IBD patients. Moreover, UC patients can benefit more from 5-ASA than CD patients. Mesalazine maintenance dosage ≥ 1.2 g/day is an effective treatment for reducing CRC risk in IBD patients.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Chemopreventive effects of 5-aminosalicylic acid on inflammatory bowel disease-associated colorectal cancer and dysplasia: a systematic review with meta-analysis

Qiu

Wang

et al. 2016

Oncotarget

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“…A cohort study by Nowacki et al showed that UC duration was strongly associated with the risk of CAC, and anti-inflammatory therapies effectively reduced the risk [53]. Moreover, in patients with Crohn's disease, only those who have colonic involvement are at risk of colon cancer, showing a direct connection between inflammation and cancer [54].…”

Section: Potential Role Of Hmgb1 In Ibd Neoplasiamentioning

confidence: 99%

Role of high-mobility group box 1 protein in inflammatory bowel disease

Wang

Gong

et al. 2015

Inflamm. Res.

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High-mobility group box 1 (HMGB1) protein is a nuclear non-histone DNA-binding protein. It is released into the extracellular milieu and mediates inflammatory responses, which contribute to the pathogenesis of numerous inflammatory diseases, including inflammatory bowel disease (IBD). An online search was performed in PubMed and Web of Science databases for articles providing evidence on the role of HMGB1 in IBD. HMGB1 plays an important role in IBD pathogenesis. Application of HMGB1 antagonists reduced inflammatory reactions and ameliorated colitis in rodent models, which may provide new insights into the diagnosis and treatment of IBD.

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“…The clinical risk factors for developing UCACD include the duration of disease, extent of disease, family history of colorectal cancer, concurrent presence of primary sclerosing cholangitis, onset at an early age, presence of backwash ileitis, and severity of histological inflammation (1)(2)(3)(4)(5). Particularly, persistent mucosal inflammation is an important risk factor for developing cancer, and it is suggested that complete resolution of mucosal inflammation may reduce the incidence of UCACD (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Ulcerative Colitis-associated Cancer/Dysplasia Detected Using Surveillance Colonoscopy Performed in the Clinical Remission Phase: A Report of Five Cases

et al. 2016

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We herein report five cases of ulcerative colitis-associated cancer/dysplasia. Although clinical remission had been achieved in all patients, mucosal inflammation had been resolved in only one patient. Thus, in order to prevent cancer from developing, appropriate medical therapy aiming not only to relieve the clinical symptoms, but also to suppress chronic inflammation appears to be necessary. Moreover, cancer occurred as early as 4 years after the diagnosis in one patient. In patients without complete resolution of mucosal inflammation, careful surveillance colonoscopy should be initiated in the early phase.

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The Risk of Colorectal Cancer in Patients with Ulcerative Colitis

Cited by 36 publications

References 44 publications

Chemopreventive effects of 5-aminosalicylic acid on inflammatory bowel disease-associated colorectal cancer and dysplasia: a systematic review with meta-analysis

Chemopreventive effects of 5-aminosalicylic acid on inflammatory bowel disease-associated colorectal cancer and dysplasia: a systematic review with meta-analysis

Role of high-mobility group box 1 protein in inflammatory bowel disease

Ulcerative Colitis-associated Cancer/Dysplasia Detected Using Surveillance Colonoscopy Performed in the Clinical Remission Phase: A Report of Five Cases

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