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P116. Risk of colorectal cancer and small bowel adenocarcinoma in Crohn's disease: A population-based study from Western Hungary, 1977–2008

P.L. Lakatos1, L.S. Kiss1, G. David2, T. Pandur2, Z. Erdelyi2, G. Mester3, M. Balogh3, I. Szipocs4, C. Molnar5, E. Komaromi6, L. Lakatos2

1Semmelweis University, Budapest, Hungary; 2Csolnoky F. Province Hospital, Veszprem, Hungary; 3Grof Eszterhazy Hospital, Papa, Hungary; 4Municipal Hospital, Tapolca, Hungary; 5Magyar Imre Hospital, Ajka, Hungary; 6Municipal Hospital, Varpalota, Hungary

Aim: Limited data are available on the incidence and predictors of colorectal (CRC) and small bowel adenocarcinoma (SBA) in patients with Crohn's disease (CD) from population-based cohorts. Since data are completely missing from Eastern Europe, our aim was to analyze the incidence and risk factors of CD associated CRC and SBA in the population-based, Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008.

Materials and Methods: The data of 506 incident CD patients were analyzed (age-at-diagnosis: 31.5, SD: 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed.

Results: CRC was diagnosed in 5 patients (5/5758 person-year-duration) during follow-up, while no patients developed SBA in this cohort. Standardized incidence ratio (SIR) of CRC was not increased overall with 5 cases observed vs 5.02 expected (SIR: 0.99, 95%CI: 0.41–2.39), however there was a tendency for increased incidence in males (5 cases observed vs 2.56 expected; SIR: 1.95, 95%CI: 0.81–4.70). Age at onset of CD (p < 0.001), male gender (p = 0.022) and stenosing disease behaviour at diagnosis (p < 0.001) were identified as risk factors for developing CRC in univariate analysis and Kaplan–Meier analysis. The cumulative risk for developing CRC after a disease duration of 20 years was 1.1% (95%CI: 0.6–1.7%).

Conclusion: The incidence of CRC and SBA was not increased in this population-based CD cohort. Age at onset of CD, male gender and stenosing disease behaviour at diagnosis were identified as risk factors of CRC.