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Risk factors associated with small bowel adenocarcinoma in Crohn's disease: a case-control study |
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| Authors: | Piton Gaël Cosnes Jacques Monnet Elisabeth Beaugerie Laurent Seksik Philippe Savoye Guillaume Cadiot Guillaume Flourie Bernard Capelle Philippe Marteau Philippe Lemann Marc Colombel Jean Frédéric Khouri Elie Bonaz Bruno Carbonnel Franck |
| Affiliation: | Service de Gastroentérologie et Nutrition, Centre Hospitalier Universitaire de Besançon;;Service de Gastroentérologie et Nutrition, Hôpital Saint-Antoine;;Département de SantéPublique, Centre Hospitalier Universitaire de Besançon;;Service de Gastroentérologie, Centre Hospitalier Universitaire de Rouen;;Service de Gastroentérologie, Centre Hospitalier Universitaire de Reim;;Service de Gastroentérologie, Centre Hospitalier Universitaire Lyon Sud;;Service de Gastroentérologie, Institut Mutualiste Montsouris, Paris;;Service de Gastroentérologie, Hôpital Lariboisière, Paris;;Service de Gastroentérologie, Hôpital Saint-Louis, Paris;;Service de Gastroentérologie, Centre Hospitalier Universitaire de Lille;;Service de Gastroentérologie, Centre Hospitalier de Chaumont;;and Service de Gastroentérologie, Centre Hospitalier Universitaire de Grenoble, France |
| Abstract: | BACKGROUND AND AIMS: 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). CONCLUSION: This study suggests that small bowel resection and prolonged salicylates use may protect against SBA in CD patients. |
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