Aminosalicylate therapy in the prevention of dysplasia and colorectal cancer in ulcerative colitis.
OBJECTIVE
Aminosalicylates have been suggested as chemopreventive agents for colorectal cancer (CRC) in ulcerative colitis (UC). We studied the effect of aminosalicylate use on dysplasia and CRC risk in chronic UC.


METHODS
UC patients with dysplasia or CRC were matched with controls by disease duration, extent, and age at diagnosis. The total amount of aminosalicylates over the duration of the disease and the mean daily amount of drug was calculated. Conditional logistic regression was used to examine the relationship of aminosalicylates to the risk of neoplasia; potential confounders were controlled in a multivariable model.


RESULTS
Twenty-six cases (8 CRC, 18 dysplasia) were matched with 96 controls. Cases and controls were similar in age (median, 43 vs 42.5 y), age at diagnosis of UC (median, 29.5 vs 30.5 y), duration of UC (median, 11.5 vs 9 y), and extent of disease (58% pancolitis), sex, family history of UC, history of primary sclerosing cholangitis, and smoking history. Cases were more likely to have a family history of CRC than controls (27% of cases, 9% of controls, P = .036). Conditional logistic regression adjusted for disease duration, age at diagnosis, and family history of CRC showed that aminosalicylate use of 1.2 g/day or more was associated with a 72% reduction in the odds of dysplasia/CRC (odds ratio, 0.28; 95% confidence interval, 0.09-0.85). As the total dose of aminosalicylates increased, the odds of dysplasia/CRC decreased (P = .056).


CONCLUSIONS
This case-control study shows a significant risk reduction of dysplasia and CRC in UC patients exposed to aminosalicylate therapy.
Rubin
David T
DT
The Reva and David Logan Center for Research in Gastrointestinal Diseases, University of Chicago, Chicago, Illinois, USA. drubin@medicine.bsd.uchicago.edu
LoSavio
Andelka
A
Yadron
Nicole
N
Huo
Dezheng
D
Hanauer
Stephen B
SB
D000328:Adult; D000636:Aminosalicylic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D016022:Case-Control Studies; D018890:Chemoprevention; D002908:Chronic Disease; D003093:Colitis, Ulcerative / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000188:drug therapy*; D012460:Sulfasalazine / Q000627:therapeutic use
D000636:Aminosalicylic Acids; D012460:Sulfasalazine; C032587:olsalazine