5-Aminosalicylic acid therapy and the risk of colorectal cancer among patients with inflammatory bowel disease

✍ Scribed by Jonathan P. Terdiman; Michael Steinbuch; William A. Blumentals; Thomas A. Ullman; David T. Rubin

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 77 KB
• Volume: 13
• Category: Article
• ISSN: 1078-0998
• DOI: 10.1002/ibd.20074

✦ Synopsis

Background:

Patients with inflammatory bowel disease (ibd) affecting the colon are at increased risk of developing colorectal cancer (crc). published data are conflicting about whether 5-aminosalicylic acid (5-asa) has chemopreventive properties against ibd-related carcinogenesis. the objective of this observational study was to determine if an association between 5-asa therapy and crc risk exists in ibd patients.

Methods:

Adult patients with a new crc diagnosis (n = 18,440) were identified from 2 large administrative claims databases. for each case, 20 control patients with no record of crc diagnosis or bowel surgery (n = 368,800) were identified.

Results:

An ibd diagnosis was associated with a 6- to 7-fold increased risk of crc (ulcerative colitis, crude odds ratio [or] = 6.72, 95% ci, 5.79-7.81; crohn's disease, crude or = 6.60, 95% ci, 5.56-7.82). among patients with ibd (364 crc cases, 1172 controls), exposure to 5-asa therapy of any dose or duration during the 12 months before crc diagnosis was not associated with a reduced risk of crc (or = 0.97; 95% ci, 0.77-1.23). however, there was a trend toward a decreased risk of crc with increasing number of mesalamine prescriptions in the previous year, though statistical significance was not achieved (trend p = 0.08).

Conclusions:

Treating ibd patients with 5-asa medications was not found to have a protective effect against colitis-related crc when assessed over a short period of exposure.