Colorectal cancer resection rates in patients with inflammatory bowel disease: a population-based study.

Background and objective: Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer (CRC). This study aimed to analyse the trends in rates of resection for IBD-related CRC in the USA.

Methods: We used the Nationwide Inpatient Sample from 1995 to 2012. Temporal trends in age-adjusted rates of resection for CRC in the setting of IBD were analysed using multivariate Joinpoint regression models. The primary outcome was surgical resection of CRC in the setting of IBD.

Results: We included 3 597 168 IBD discharges in the present study, of which 275 479 underwent CRC resection between 1995 and 2012. The annual CRC resection rates among IBD population decreased significantly from 1995 to 2012. This decrease was significant in all age groups with an annual decrease of 393 ( P  <   0.001), 359 ( P  <   0.001), 293 ( P  <   0.001) and 159 ( P  <   0.001) per 100 000 IBD discharges between 1995 and 2012 for age groups 18-39, 40-49, 50-74 and >75 years, respectively. The annual IBD-CRC resection rate per 100 000 IBD discharges for proximal CRC decreased by 149 ( P  <   0.001), 130 ( P  <   0.001), 95 ( P  <   0.001) and 50 ( P  <   0.001), respectively, and the annual distal CRC resections per 100 000 IBD discharges decreased by 104 ( P  <   0.001), 123 ( P  <   0.001), 123 ( P  <   0.001) and 82 ( P  <   0.001), respectively, for age groups 18-39, 40-49, 50-74 and >75 years, between 1995 and 2012. On multivariate Poisson regression analysis, after adjustment for age and sex, CRC resections decreased by 3.9% each year from 1995 to 2012.

Conclusions: CRC resection rates among IBD patients have continued to decrease annually from 1995 to 2012. There is a population-level decrease in resection of both proximal and distal CRC reflecting a decreasing incidence of IBD-related CRC incidence in the USA.