Colorectal Cancer Risk Higher Among Patients WIth PSC, With or Without IBD

Although the risk of colorectal cancer (CRC) was higher in patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD), patients with PSC alone had an increased risk of CRC compared with the general population, according to a study published online ahead of print in Hepatology Research.

“Individuals with PSC alone may require extended screening and surveillance colonoscopy intervals compared with those with PSC–IBD, yet still require more frequent monitoring than screening guidelines recommend for the general population,” wrote corresponding author Taranika Sarkar Das, MD, of NYU Langone Medical Center, New York, New York, and study coauthors.

The retrospective study included a total 140 patients diagnosed between January 1, 1986, and June 1, 2023, and followed for 526.6 person-years at NYU Langone Health settings. Among the patients, 30 had PSC-IBD and 110 had PSC alone. While PSC is known to increase the risk of CRC in patients with IBD, researchers analyzed patient data and colonoscopy findings to assess whether PSC alone was an independent risk factor for CRC.

Rates of CRC were 23.3% in patients with PSC–IBD and 1.8% in patients with PSC alone, according to the study. Rates of low-grade or uncharacterized dysplasia were 16.7% in patients with PSC–IBD and 0% in patients with PSC only.

Nevertheless, PSC-only patients had a significantly elevated CRC risk compared with the standard NYU Langone population. Researchers reported a standardized incidence ratio of 9.2 for patients with PSC alone.

“Our study revealed a significantly heightened CRC risk in PSC–IBD patients compared with those with PSC only,” researchers wrote. “Importantly, individuals with PSC only also face a greater CRC risk compared with the general population.”

Reference

Das TS, Ho K, Udaikumar J, et al. Risk of colorectal cancer in patients with primary sclerosing cholangitis and concomitant inflammatory bowel disease compared with primary sclerosing cholangitis only. Hepatol Res. Published online February 28, 2024. doi:10.1111/hepr.14029