Risks of Surgery Decrease in UC and CD Patients

A recent study revealed that the overall risk of surgery for patients with ulcerative colitis (UC) and Crohn disease (CD) has decreased among contemporary cohorts to a 5-year cumulative risk of surgery for patients with UC of 7.0% and for patients with CD of 18.0%.

Investigators conducted this systematic review and meta-analysis to estimate the rates and trends of colectomy in patients with UC, and of primary and re-resection in patients with CD. Identifying population-based cohort studies up to September 3, 2019, the researchers evaluated overall and contemporary (after 2000) risk of surgery. A total of 48 studies were investigated, 26 of them pertaining to patients with UC, and 22 to patients with CD.

Among patients with UC, the overall 1-, 5-, and 10-year risks of colectomy were 4.0%, 8.8%, and 13.3%, respectively. Contemporary risks shown in these studies were 2.8%, 7.0%, and 9.6%.

For patients with CD, the overall 1-, 5-, and 10-year risks of surgery were 18.7%, 28.0%, and 39.5% respectively. Contemporary risks shown were 12.3%, 18.0%, and 26.2%.

Both the UC and CD studies showed a decrease of risk over time (P < .001).

Researchers also completed a meta-analysis of 8 studies among patients with CD with prior resection. The cumulative risk of a second resection at 5 years after the first resection was 17.7%, and at 10 years after the first resection it was 31.3%.

The researchers noted that this significant decrease of patient-level risks of surgery “may be related to early detection and/or better treatment.”

—Allison Casey

Reference:

Tsai L, Ma C, Dulai PS. Contemporary risk of surgery in patients with ulcerative colitis and Crohn’s disease: A meta-analysis of population-based cohorts. Syst Rev. 2021;19(10):P2031-2045.