Risk factors associated with small bowel adenocarcinoma in Crohn's disease: a case-control study.
OBJECTIVE
It is well established that Crohn's disease (CD) is associated with an increased risk of small bowel adenocarcinoma (SBA). The data concerning SBA risk factors in CD are scanty. The aim of this study was to identify them.


METHODS
In 11 French centers affiliated with the GETAID (Groupe d'Etude Thérapeutique des Affections Inflammatoires du Tube Digestif), we identified 29 patients with CD and SBA. Eighty-seven CD controls without SBA recruited in a single center were matched to the cases for sex, age, duration, and CD site. A conditional logistic regression, taking into account the matching between cases and controls, was performed.


RESULTS
In univariate analysis, the cases had had significantly less small bowel resection and received prolonged treatment with salicylates (more than 2 yr), less often than the controls (odds ratio, OR [95% confidence interval, CI] 0.07 [0.01-0.32] and 0.29 [0.10-0.82], respectively). In multivariate analysis, both associations remained significant (OR 0.04 [0.01-0.28], P= 0.001; OR 0.16 [0.03-0.79], P= 0.02, respectively).


CONCLUSIONS
This study suggests that small bowel resection and prolonged salicylates use may protect against SBA in CD patients.
Service de Gastroentérologie et Nutrition, Centre Hospitalier Universitaire de Besançon, France.
Gaël
G
Piton
Jacques
J
Cosnes
Elisabeth
E
Monnet
Laurent
L
Beaugerie
Philippe
P
Seksik
Guillaume
G
Savoye
Guillaume
G
Cadiot
Bernard
B
Flourie
Philippe
P
Capelle
Philippe
P
Marteau
Marc
M
Lemann
Jean Frédéric
JF
Colombel
Elie
E
Khouri
Bruno
B
Bonaz
Franck
F
Carbonnel
D000230:Adenocarcinoma / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D003424:Crohn Disease / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000209:etiology*; D007421:Intestine, Small / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012459:Salicylates / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D012459:Salicylates