Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Risk Factors Associated With Small Bowel Adenocarcinoma in Crohn's Disease

A Case–Control Study

Piton, Gaël, M.D.1; Cosnes, Jacques, M.D., Ph.D.2; Monnet, Elisabeth, M.D., Ph.D.3; Beaugerie, Laurent, M.D., Ph.D.2; Seksik, Philippe, M.D., Ph.D.2; Savoye, Guillaume, M.D., Ph.D.4; Cadiot, Guillaume, M.D., Ph.D.5; Flourie, Bernard, M.D., Ph.D.6; Capelle, Philippe, M.D.7; Marteau, Philippe, M.D., Ph.D.8; Lemann, Marc, M.D., Ph.D.9; Colombel, Jean Frédéric, M.D., Ph.D.10; Khouri, Elie, M.D.11; Bonaz, Bruno, M.D., Ph.D.12; Carbonnel, Franck, M.D., Ph.D.1

American Journal of Gastroenterology: July 2008 - Volume 103 - Issue 7 - p 1730–1736
ORIGINAL CONTRIBUTION: INFLAMMATORY BOWEL DISEASE
Buy

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.

1Service de Gastroentérologie et Nutrition, Centre Hospitalier Universitaire de Besançon; 2Service de Gastroentérologie et Nutrition, Hôpital Saint-Antoine; 3Département de Santé Publique, Centre Hospitalier Universitaire de Besançon; 4Service de Gastroentérologie, Centre Hospitalier Universitaire de Rouen; 5Service de Gastroentérologie, Centre Hospitalier Universitaire de Reim; 6Service de Gastroentérologie, Centre Hospitalier Universitaire Lyon Sud; 7Service de Gastroentérologie, Institut Mutualiste Montsouris, Paris; 8Service de Gastroentérologie, Hôpital Lariboisière, Paris; 9Service de Gastroentérologie, Hôpital Saint-Louis, Paris; 10Service de Gastroentérologie, Centre Hospitalier Universitaire de Lille; 11Service de Gastroentérologie, Centre Hospitalier de Chaumont; and 12Service de Gastroentérologie, Centre Hospitalier Universitaire de Grenoble, France

Reprint requests and correspondence: Franck Carbonnel, M.D., Ph.D., Service de Gastroentérologie et Nutrition, Centre Hospitalier Universitaire de Besançon, France.

CONFLICT OF INTEREST

Guarantor of the article: Franck Carbonnel.

Specific author contributions: Gaël Piton collated and analyzed the data. He also wrote the different versions of the manuscript. Jacques Cosnes contributed to the conception of the study and was involved in the diagnosis, data collection, and clinical care of many cases and all controls. Elisabeth Monnet contributed to the analysis of the data. Laurent Beaugerie, Philippe Seksik, Guillaume Savoye, Guillaume Cadiot, Bernard Flourie, Philippe Capelle, Philippe Marteau, Marc Lemann, Jean Frédéric Colombel, Elie Khouri, and Bruno Bonaz were involved in the diagnosis, data collection, and clinical care of the subjects. Franck Carbonnel conceived the study. All authors contributed to the drafting of the manuscript and revising it for important intellectual content.

Financial support: No financial support was received for the study. The invitation of GP to the Digestive Disease Week, 2007, in Washington DC, for oral presentation of this study, was paid by Ferring Laboratories.

Potential competing interests: Jean Frédéric Colombel has received grant support from Ferring and participated in continuing medical education events supported by unrestricted educational grants from Ferring. Phillippe Marteau has received honoraria for consulting and participated in continuing medical education events supported by unrestricted educational grants from Ferring. Marc Lemann participated in continuing medical education events supported by unrestricted educational grants from Ferring and has received honoraria from Shire for consulting. Franck Carbonnel participated in continuing medical education events supported by unrestricted educational grants from Ferring and Norgine. Laurent Beaugerie has received grant support from Ferring.

Received October 18, 2007; accepted January 7, 2008.

© The American College of Gastroenterology 2008. All Rights Reserved.
You currently do not have access to this article

To access this article:

Note: If your society membership provides full-access, you may need to login on your society website