Risk of Small Intestine Cancer in Inflammatory Bowel Disease: A Propensity-Matched Study From a Large Multicenter Database in the United States
Saqr Alsakarneh, Mohamed Ahmed, Samiya Azim, Jana G. Hashash, Francis A. Farraye, Hassan Ghoz
Abstract
INTRODUCTION: The risk of small bowel cancer (SBC) in inflammatory bowel disease (IBD) is unclear. We compared the recent trends of SBC in patients with IBD and stratified them based on disease type. METHODS: We used TriNetX database to access the electronic health records for patients with IBD, ulcerative colitis (UC) and Crohn's disease (CD) from 2005-2024. We used propensity score matching to compare the rate of SBC in patients with IBD, UC, and CD compared to the general population. We adjusted for all known confounders. RESULTS: From 2010-2024, there was an increasing trend of diagnosed SBC in patients with IBD, with an Average Annual Percentage Change (AAPC) of 3.2% (P<0.001). Patients with CD (aHR = 4.83; 95% CI: 3.58 - 6.53; P < .0001) had an increased risk of SBC compared to the general population without IBD, as well as patients with UC (aHR = 2.28; 95% CI: 1.65 - 3.14; P < .0001). The ileum was the most common location across all subgroups. CONCLUSION: Both patients with CD and, interestingly, UC had an elevated risk for developing SBC compared to the general population.