TY - JOUR
T1 - Intestinal cancer in patients with Crohn's disease
T2 - A systematic review and meta-analysis
AU - Uchino, Motoi
AU - Ikeuchi, Hiroki
AU - Hata, Keisuke
AU - Minagawa, Tomohiro
AU - Horio, Yuki
AU - Kuwahara, Ryuichi
AU - Nakamura, Shiro
AU - Watanabe, Kenji
AU - Saruta, Masayuki
AU - Fujii, Toshimitsu
AU - Kobayashi, Taku
AU - Sugimoto, Ken
AU - Hirai, Fumihito
AU - Esaki, Motohiro
AU - Hiraoka, Sakiko
AU - Matsuoka, Katsuyoshi
AU - Shinzaki, Shinichiro
AU - Matsuura, Minoru
AU - Inoue, Nagamu
AU - Nakase, Hiroshi
AU - Watanabe, Mamoru
N1 - Funding Information:
This work was partially supported by the Japanese Society of Gastroenterology. Financial support:
Publisher Copyright:
© 2020 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd
PY - 2021/2
Y1 - 2021/2
N2 - Background and Aim: Although surveillance colonoscopy is recommended by several guidelines for Crohn's disease (CD), the evidence is insufficient to support the validity of this recommendation. Moreover, the efficacy of surveillance colonoscopy for anorectal cancer remains unclear. Therefore, we performed a systematic review of cancer in patients with CD before considering the proper surveillance methods. Methods: We conducted a systematic review and meta-analysis examining the incidence of intestinal cancer and a literature review to clarify the characteristic features of cancer in CD. We performed the systematic literature review of studies published up to May 2019. Results: Overall, 7344 patients were included in eight studies. The standardized incidence ratios (95% confidence intervals) of colorectal cancer (CRC) and small bowel cancer (SBC) were 2.08 (1.43–3.02) and 22.01 (9.10–53.25), respectively. The prevalence of CRC and SBC was 57/7344 (0.77%) and 17/7344 (0.23%), respectively, during a median follow-up of 12.55 years. Additionally, 54 studies reporting 208 anorectal cancer cases were identified. In patients with anorectal cancer, the prognosis for survival was 2.1 ± 2.3 years, and advanced cancer greater than stage T3 occurred in 46/74 patients (62.1%). Many more reports of anorectal cancer were published in Asia than in Western countries. Conclusion: Although we were unable to state a recommendation for surveillance for SBC, we should perform cancer surveillance for CRC in patients with CD. However, the characteristics of cancer may differ according to geography or race. We must establish proper and effective surveillance methods that are independently suitable to detect these differences.
AB - Background and Aim: Although surveillance colonoscopy is recommended by several guidelines for Crohn's disease (CD), the evidence is insufficient to support the validity of this recommendation. Moreover, the efficacy of surveillance colonoscopy for anorectal cancer remains unclear. Therefore, we performed a systematic review of cancer in patients with CD before considering the proper surveillance methods. Methods: We conducted a systematic review and meta-analysis examining the incidence of intestinal cancer and a literature review to clarify the characteristic features of cancer in CD. We performed the systematic literature review of studies published up to May 2019. Results: Overall, 7344 patients were included in eight studies. The standardized incidence ratios (95% confidence intervals) of colorectal cancer (CRC) and small bowel cancer (SBC) were 2.08 (1.43–3.02) and 22.01 (9.10–53.25), respectively. The prevalence of CRC and SBC was 57/7344 (0.77%) and 17/7344 (0.23%), respectively, during a median follow-up of 12.55 years. Additionally, 54 studies reporting 208 anorectal cancer cases were identified. In patients with anorectal cancer, the prognosis for survival was 2.1 ± 2.3 years, and advanced cancer greater than stage T3 occurred in 46/74 patients (62.1%). Many more reports of anorectal cancer were published in Asia than in Western countries. Conclusion: Although we were unable to state a recommendation for surveillance for SBC, we should perform cancer surveillance for CRC in patients with CD. However, the characteristics of cancer may differ according to geography or race. We must establish proper and effective surveillance methods that are independently suitable to detect these differences.
KW - Anorectal cancer
KW - Colorectal
KW - Colorectal cancer: Epidemiology and surveillance
KW - Crohn's disease
KW - Intestinal cancer
KW - Small bowel cancer
UR - http://www.scopus.com/inward/record.url?scp=85091729515&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85091729515&partnerID=8YFLogxK
U2 - 10.1111/jgh.15229
DO - 10.1111/jgh.15229
M3 - Article
C2 - 32865278
AN - SCOPUS:85091729515
SN - 0815-9319
VL - 36
SP - 329
EP - 336
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
IS - 2
ER -
