Association between irritable bowel syndrome and colorectal cancer: a nationwide population-based study

Cheng-Wen Hsiao; Wen-Yen Huang; Tao-Wei Ke; Chih-Hsin Muo; William Tzu-Liang Chen; Fung-Chang Sung; Chia-Hung Kao

doi:10.1016/j.ejim.2013.11.005

Association between irritable bowel syndrome and colorectal cancer: a nationwide population-based study

Eur J Intern Med. 2014 Jan;25(1):82-6. doi: 10.1016/j.ejim.2013.11.005. Epub 2013 Nov 20.

Authors

Cheng-Wen Hsiao¹, Wen-Yen Huang², Tao-Wei Ke³, Chih-Hsin Muo⁴, William Tzu-Liang Chen³, Fung-Chang Sung⁵, Chia-Hung Kao⁶

Affiliations

¹ Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
² Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
³ Division of Colorectal Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan.
⁴ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
⁵ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University and Hospital, Taichung, Taiwan.
⁶ Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.

PMID: 24268837
DOI: 10.1016/j.ejim.2013.11.005

Abstract

Objectives: To determine whether irritable bowel syndrome (IBS) is associated with an increased risk for the subsequent colorectal cancer (CRC).

Methods: We identified 91,746 patients who were diagnosed with IBS between 2000 and 2010 from the Taiwan National Health Insurance Research Database (NHIRD) as the study cohort, and randomly extracted the data of 183,492 patients matched by sex, age, and baseline year for the comparison cohort. The follow-up period was terminated after CRC development, withdrawal from the national health insurance (NHI) system, or at the end of 2010. Cumulative incidences and hazard ratios (HRs) of CRC development were determined.

Results: During the first 2years of follow-up, the subsequent CRC incidence rates in the IBS and comparison cohorts were 37.3 and 5.61 per 10,000person-years, respectively (adjusted HR, 6.72; 95% CI, 5.70-7.92; p<.0001). Thereafter, the risk did not differ significantly between the 2 cohorts (adjusted HR, 1.08; 95% CI, 0.93-1.26); the participants in the IBS cohort commonly underwent more colonoscopies/sigmoidoscopies than did the non-IBS cohort.

Conclusions: IBS was not associated with the long-term development of CRC in Taiwan. The increased risk of CRC in the first 2years may have occurred because some CRC patients were initially misclassified as IBS patients.

Keywords: Cohort study; Colorectal cancer; Irritable bowel syndrome.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cohort Studies
Colonoscopy / statistics & numerical data
Colorectal Neoplasms / diagnosis
Colorectal Neoplasms / epidemiology*
Databases, Factual
Diabetes Mellitus / epidemiology
Female
Follow-Up Studies
Humans
Hyperlipidemias / epidemiology
Hypertension / epidemiology
Incidence
Irritable Bowel Syndrome / diagnosis
Irritable Bowel Syndrome / epidemiology*
Male
Middle Aged
Proportional Hazards Models
Risk Factors
Taiwan / epidemiology
Young Adult