The Incidence and Disease Course of Perianal Crohn's Disease: A Danish Nationwide Cohort Study, 1997-2015.
J Crohns Colitis
; 15(1): 5-13, 2021 Jan 13.
Article
in En
| MEDLINE
| ID: mdl-32582937
ABSTRACT
BACKGROUND AND AIMS:
Perianal Crohn's disease [CD] places a considerable burden on patients' quality of life and is complex to treat. Despite its impact and high frequency, few studies have investigated the incidence and disease course of perianal CD. The aim of this study was to assess the incidence and disease course of perianal CD in adult patients throughout a 19-year period.METHODS:
The cohort comprised all individuals aged 18 years or older who were diagnosed with CD in Denmark between January 1, 1997, and December 31, 2015, according to the National Patient Registry [NPR].RESULTS:
A total of 1812 [19%] out of 9739 patients with CD were found to have perianal CD. Perianal fistulas were the most common manifestation, accounting for 943 [52%] cases. The incidence of perianal CD remained stable over time. Patients with perianal CD were found to have an increased risk of undergoing major abdominal surgery compared with patients without perianal CD (hazard ratio 1.51, 95% confidence interval [CI] 1.40 to 1.64, pâ <0.001) in a multivariate Cox regression analysis. The incidence rate ratios of anal and rectal cancer in perianal CD patients were 11.45 [95% CI 4.70 to 27.91, pâ <0.001] and 2.29 [95% CI 1.25 to 4.20, pâ =â 0.006], respectively, as compared with non-IBD matched controls.CONCLUSIONS:
In this nationwide study, 19% of CD patients developed perianal disease. Patients with perianal CD were at increased risk of undergoing major surgery compared with non-perianal CD patients. The risk of anal and rectal cancer was increased in patients with perianal CD compared with non-IBD matched controls. PODCAST This article has an associated podcast which can be accessed at https//academic.oup.com/ecco-jcc/pages/podcast.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Anus Diseases
/
Quality of Life
/
Rectal Neoplasms
/
Digestive System Surgical Procedures
/
Crohn Disease
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
J Crohns Colitis
Journal subject:
GASTROENTEROLOGIA
Year:
2021
Type:
Article
Affiliation country:
Denmark