title: Intestinal cancer risk in Crohn's disease: a meta-analysis.
abstract: OBJECTIVE
  To clarify the intestinal cancer risk in Crohn's disease (CD).
  
  
  METHODS
  20 clinical studies (1965-2008) with a total of 40,547 patients with Crohn's disease-associated cancer (CDAC) were included in the meta-analysis ("inverse variance weighted" method).
  
  
  RESULTS
  The incidence of CDAC in any CD patient was 0.8/1,000 person years duration (pyd) (CI, 0.6-1.0). The incidences of different carcinomas were: colorectal cancer 0.5/1,000 pyd (CI, 0.3-0.6), small bowel carcinoma 0.3/1,000 pyd (CI, 0.1-0.5), and cancers arising from CD-associated fistulae 0.2/1,000 pyd (CI, 0.0-0.4). Compared to the incidence in an age-matched standard population, the risk of colorectal cancer was increased by factor 2-3 and of small bowel cancer by factor 18.75, respectively. Mean patient age at diagnosis of CD-associated colorectal cancer was 51.5 years, thus 20 years earlier than in a standard population. The mean duration of CD until diagnosis of CDAC was 18.3 years. Duration of CD, age at diagnosis of CD, and anatomical area of CD involvement had no significant influence on cancer incidence.
  
  
  CONCLUSIONS
  CD is a risk factor for colorectal cancer, small bowel cancer, and fistula cancer; however, compared to ulcerative colitis, cancer risk is moderate.
authors.affiliation: Department of General and Visceral Surgery, University of Münster, Waldeyerstr. 1, 48149 Münster, Germany.
authors.forename: Mike Georg
authors.initials: MG
authors.lastname: Laukoetter
authors.forename: Rudolf
authors.initials: R
authors.lastname: Mennigen
authors.forename: C Mareike
authors.initials: CM
authors.lastname: Hannig
authors.forename: Nani
authors.initials: N
authors.lastname: Osada
authors.forename: Emile
authors.initials: E
authors.lastname: Rijcken
authors.forename: Thorsten
authors.initials: T
authors.lastname: Vowinkel
authors.forename: Christian F
authors.initials: CF
authors.lastname: Krieglstein
authors.forename: Norbert
authors.initials: N
authors.lastname: Senninger
authors.forename: Christoph
authors.initials: C
authors.lastname: Anthoni
authors.forename: Matthias
authors.initials: M
authors.lastname: Bruewer
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000150:complications*; D006801:Humans; D015994:Incidence; D007414:Intestinal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology