title: Risk of colorectal cancer and small bowel adenocarcinoma in Crohn's disease: a population-based study from western Hungary 1977-2008.
abstract: OBJECTIVE
  Limited data are available on the incidence and predictors of colorectal (CRC) and small bowel adenocarcinoma (SBA) in patients with Crohn's disease (CD) from population-based cohorts. Since data are completely missing from Eastern Europe, our aim was to analyze the incidence and risk factors of CD associated CRC and SBA in the population-based, Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008.
  
  
  METHODS
  The data of 506 incident CD patients were analyzed (age-at-diagnosis: 31.5, SD: 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed.
  
  
  RESULTS
  CRC was diagnosed in five patients (5/5758 person-year-duration) during follow-up, while no patients developed SBA in this cohort. Standardized incidence ratio (SIR) of CRC was not increased overall with five cases observed vs. 5.02 expected (SIR: 0.99, 95% CI: 0.41-2.39); however, there was a tendency for increased incidence in males (five cases observed vs. 2.56 expected; SIR: 1.95, 95% CI: 0.81-4.70). Age at onset of CD (p<0.001), male gender (p=0.022) and stenosing disease behavior at diagnosis (p<0.001) but not disease location were identified as risk factors for developing CRC in univariate analysis and Kaplan-Meier analysis. The cumulative risk for developing CRC after a disease duration of 20 years was 1.1% (95% CI: 0.6-1.7%).
  
  
  CONCLUSIONS
  The incidence of CRC and SBA was not increased in this population-based CD cohort. Age at onset of CD, male gender and stenosing disease behavior at diagnosis were identified as risk factors of CRC.
authors: 1st Department of Medicine, Semmelweis University, Budapest, Hungary. kislakpet@bel1.sote.hu
authors: Peter Laszlo
authors: PL
authors: Lakatos
authors: Gyula
authors: G
authors: David
authors: Tunde
authors: T
authors: Pandur
authors: Zsuzsanna
authors: Z
authors: Erdelyi
authors: Gabor
authors: G
authors: Mester
authors: Mihaly
authors: M
authors: Balogh
authors: Istvan
authors: I
authors: Szipocs
authors: Csaba
authors: C
authors: Molnar
authors: Erzsebet
authors: E
authors: Komaromi
authors: Lajos S
authors: LS
authors: Kiss
authors: Laszlo
authors: L
authors: Lakatos
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D007223:Infant; D007414:Intestinal Neoplasms / Q000150:complications* / Q000453:epidemiology*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012907:Smoking; D055815:Young Adult