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Plain language summary:

Background:


Inflammatory Bowel Disease (IBD) is a term which is mainly used to describe two conditions; ulcerative colitis and Crohn’s disease. Having IBD means a patient is more at risk of developing bowel cancer.

This study examined the characteristics, surgical treatment and outcomes of patients with bowel cancer and IBD in the English NHS to find out how they are different from patients who are diagnosed with bowel cancer and do not have IBD.

What did we do?


Using data from the English NHS, we looked at all bowel cancers that had been diagnosed between 2005 and 2018 in patients both with and without a prior diagnosis of IBD. We then compared the characteristics of the two groups and looked at the outcomes of the patients after two years.

What did we find?


We found that patients with IBD who have bowel cancer tend to be younger than patients without IBD and they are more likely to be diagnosed as an emergency rather than through other routes such as the Bowel Cancer Screening Programme, the 2 Week Wait or others. Patients with IBD are also more likely to have right sided colon tumours. 36.3% of patients with IBD and bowel cancer underwent a total colectomy which is an operation to remove all of the colon known as a total colectomy . Twice as many patients with IBD and bowel cancer than people without IBD were diagnosed with another tumour following their initial diagnosis. The two year survival for IBD bowel cancer patients was worse than for patients without IBD.

Conclusion:


As bowel cancer associated with IBD occurs in younger patients and has worse survival outcomes, it is important that further work is done to find out the reasons for this so that better screening, surveillance and treatment strategies can be developed.

Project Outputs

Publication Birch, Rebecca J. PhD1,*; Burr, Nicholas BSc, MBBS, MRCP, MD1,2,3,*; Subramanian, Venkataraman MRCP, MD1,4; Tiernan, Jim P. PhD, FRCS4; Hull, Mark A. PhD, FRCP1,4; Finan, Paul MBChB, MD, FRCS1; Rose, Azmina BSc Hons, ATT PG Cert/Dip5; Rutter, Matthew MBBS, MD, FRCP6,7; Valori, Roland MD, FRCP, MSc (Oxon)8; Downing, Amy PhD1; Morris, Eva J.A. PhD Inflammatory Bowel Disease-Associated Colorectal Cancer Epidemiology and Outcomes: An English Population-Based Study. The American Journal of Gastroenterology