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

Jonathan P. Terdiman, Michael Steinbuch, William A. Blumentals, Thomas A. Ullman, David T. Rubin

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)367-371
Number of pages5
JournalInflammatory Bowel Diseases
Volume13
Issue number4
DOIs
StatePublished - Apr 1 2007
Externally publishedYes

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Mesalamine
Inflammatory Bowel Diseases
Colorectal Neoplasms
Therapeutics
Odds Ratio
Colitis
Ulcerative Colitis
Crohn Disease
Observational Studies
Prescriptions
Colon
Carcinogenesis
Databases

Keywords

  • 5-aminosalicylic acids
  • Case-control study
  • Colitis
  • Colorectal cancer
  • Inflammatory bowel disease

ASJC Scopus subject areas

  • Gastroenterology

Cite this

5-Aminosalicylic acid therapy and the risk of colorectal cancer among patients with inflammatory bowel disease. / Terdiman, Jonathan P.; Steinbuch, Michael; Blumentals, William A.; Ullman, Thomas A.; Rubin, David T.

In: Inflammatory Bowel Diseases, Vol. 13, No. 4, 01.04.2007, p. 367-371.

Research output: Contribution to journalArticle

Terdiman, Jonathan P. ; Steinbuch, Michael ; Blumentals, William A. ; Ullman, Thomas A. ; Rubin, David T. / 5-Aminosalicylic acid therapy and the risk of colorectal cancer among patients with inflammatory bowel disease. In: Inflammatory Bowel Diseases. 2007 ; Vol. 13, No. 4. pp. 367-371.
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abstract = "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.",
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