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P624. Risk of colorectal cancer in CD patients with colonic involvement and stenosing disease. Results from a population-based study

P.A. Golovics1, L. Lakatos2, B.D. Lovasz1, G. David2, T. Pandur2, Z. Erdelyi2, G. Mester3, M. Balogh3, I. Szita2, C. Molnar4, E. Komaromi5, Z. Vegh1, M. Mandel1, L.S. Kiss1, P. Lakatos1, 1Semmelweis University, 1st Department of Medicine, Budapest, Hungary, 2Csolnoky F. Province Hospital, 1st Department of Medicine, Veszprem, Hungary, 3Grof Eszterhazy Hospital, Papa, Hungary, 4Magyar Imre Hospital, Ajka, Hungary, 5Municipal Hospital, Varpalota, Hungary

Background

Since data are limited our aim was to study the risk of colorectal cancer (CRC) in patients Crohn's disease (CD) presenting with stenosing colonic lesions in the population-based, Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008.

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 total 5 CD patients (total follow-up: 5758 person-years) during follow-up. 47 patients presented with colonic/ileocolonic disease and a stenotic lesion in the colon. The total follow-up was 502 person-years (mean: 10.6 SD 7.1 years). CRC developed in 3 patients (6.3%), equalling 0.6/100 person-years. In a Kaplan–Meier analysis the probability of developing CRC was 4.7% after 5 years and 7% after 10 years of disease duration. In a sensitivity analysis, we included all patients who presented with colonic/ileocolonic disease and a stenosing colonic lesion at diagnosis or during follow-up (n = 66, total follow-up: 734 person-years, mean: 11.2 SD 8.3 years). The prevalence of cancer was overall 4.5% (0.4/100 person-years). In a Kaplan–Meier analysis the probability of developing CRC was 3.3% and 5.1% after 5 and 10 years of disease duration.

Conclusion

The risk to develop CRC in colonic CD patients presenting with or developing a stenotic lesion in the colon is high already after relatively short disease duration suggesting the need for careful surveillance of these patients.