Issue 22

Clinical Question

What is the overall survival rate for patients with IBD who develop colorectal cancer (CRC) relative to those without IBD?

Editor’s Bottom Line

IBD patients who develop CRC have a higher mortality rate (usually from proximal tumours) than CRC patients without IBD.

Reference

Ou B, Zhao J, Guan S, et al. Survival of Colorectal Cancer in Patients With or Without Inflammatory Bowel Disease: A Meta-Analysis. Dig Dis Sci. 2016 Mar;61(3):881–9. https://www.ncbi.nlm.nih.gov/pubmed/26518415

Synopsis

To compare CRC overall survival rates between patients with IBD and those without, a meta-analysis was conducted in which hazard ratios (HR) and 95% confidence intervals (CI) were pooled. A total of 12 studies were selected, from 1961 to 2014, all of which were retrospective and followed survival outcomes in those who mainly received surgical therapy. A total of 3472 IBD patients were included.

The study found the overall survival HR to be 1.24 (95% CI: 1.19–1.29), indicating a 24% increase in mortality for IBD patients at any time point compared to non-IBD patients. IBD patients had an odds ratio (OR) of 2.52 for CRC involving the proximal colon (95% CI: 1.35–4.72). In turn, this particular site was associated with increased odds of a more aggressive type of tumour in IBD patients (OR 1.59; 95% CI: 1.26–1.99).

Details

Study Design: Expert Meta-analysis
Funding: None
Allocation: n/a
Setting: n/a
Level of Evidence: 1a (Oxford Levels of Evidence)

The summary and conclusion in this issue of E-mentoring in IBD pertains to the manuscript(s) being reviewed, and should be considered in the context of what is already known surrounding the topic and incorporated into practice as deemed appropriate by the individual learner.