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5-Aminosalicylic acid therapy and the risk of colorectal cancer among patients with inflammatory bowel disease

Authors

  • Jonathan P. Terdiman MD,

    Corresponding author
    1. University of California, San Francisco, San Francisco, California
    • Box 1623, University of California, San Francisco, San Francisco, CA 94143-1623
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    • Dr. Terdiman has served as a consultant and speaker for Procter & Gamble Pharmaceuticals, Inc. and Salix Pharmaceuticals; Dr. Steinbuch is an employee and stockholder of Procter & Gamble Pharmaceuticals, Inc. Dr. Blumentals is an employee of Roche Laboratories, Inc. Dr. Ullman has received grant support from and served as a speaker for Procter & Gamble Pharmaceuticals, Inc., and received honoraria from Shire Pharmaceuticals. Dr. Rubin is a consultant for Procter & Gamble Pharmaceuticals, Inc., Salix Pharmaceuticals, and Shire Pharmaceuticals. He receives grant support from Procter & Gamble Pharmaceuticals, Inc., and has served as a speaker for Procter & Gamble Pharmaceuticals, Inc., and Salix Pharmaceuticals.

  • Michael Steinbuch PhD,

    1. Procter & Gamble Pharmaceuticals, Inc., Mason, Ohio
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    • Dr. Terdiman has served as a consultant and speaker for Procter & Gamble Pharmaceuticals, Inc. and Salix Pharmaceuticals; Dr. Steinbuch is an employee and stockholder of Procter & Gamble Pharmaceuticals, Inc. Dr. Blumentals is an employee of Roche Laboratories, Inc. Dr. Ullman has received grant support from and served as a speaker for Procter & Gamble Pharmaceuticals, Inc., and received honoraria from Shire Pharmaceuticals. Dr. Rubin is a consultant for Procter & Gamble Pharmaceuticals, Inc., Salix Pharmaceuticals, and Shire Pharmaceuticals. He receives grant support from Procter & Gamble Pharmaceuticals, Inc., and has served as a speaker for Procter & Gamble Pharmaceuticals, Inc., and Salix Pharmaceuticals.

  • William A. Blumentals PhD,

    1. Roche Laboratories, Inc., Nutley, New Jersey
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  • Thomas A. Ullman MD,

    1. Mount Sinai School of Medicine, New York, New York
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    • Dr. Terdiman has served as a consultant and speaker for Procter & Gamble Pharmaceuticals, Inc. and Salix Pharmaceuticals; Dr. Steinbuch is an employee and stockholder of Procter & Gamble Pharmaceuticals, Inc. Dr. Blumentals is an employee of Roche Laboratories, Inc. Dr. Ullman has received grant support from and served as a speaker for Procter & Gamble Pharmaceuticals, Inc., and received honoraria from Shire Pharmaceuticals. Dr. Rubin is a consultant for Procter & Gamble Pharmaceuticals, Inc., Salix Pharmaceuticals, and Shire Pharmaceuticals. He receives grant support from Procter & Gamble Pharmaceuticals, Inc., and has served as a speaker for Procter & Gamble Pharmaceuticals, Inc., and Salix Pharmaceuticals.

  • David T. Rubin MD

    1. University of Chicago, Chicago, Illinois
    Search for more papers by this author
    • Dr. Terdiman has served as a consultant and speaker for Procter & Gamble Pharmaceuticals, Inc. and Salix Pharmaceuticals; Dr. Steinbuch is an employee and stockholder of Procter & Gamble Pharmaceuticals, Inc. Dr. Blumentals is an employee of Roche Laboratories, Inc. Dr. Ullman has received grant support from and served as a speaker for Procter & Gamble Pharmaceuticals, Inc., and received honoraria from Shire Pharmaceuticals. Dr. Rubin is a consultant for Procter & Gamble Pharmaceuticals, Inc., Salix Pharmaceuticals, and Shire Pharmaceuticals. He receives grant support from Procter & Gamble Pharmaceuticals, Inc., and has served as a speaker for Procter & Gamble Pharmaceuticals, Inc., and Salix Pharmaceuticals.


Abstract

Background: Patients with inflammatory bowel disease (IBD) affecting the colon are at increased risk of developing colorectal cancer (CRC). Published data are conflicting about whether 5-aminosalicylic acid (5-ASA) has chemopreventive properties against IBD-related carcinogenesis. The objective of this observational study was to determine if an association between 5-ASA therapy and CRC risk exists in IBD patients.

Methods: Adult patients with a new CRC diagnosis (n = 18,440) were identified from 2 large administrative claims databases. For each case, 20 control patients with no record of CRC diagnosis or bowel surgery (n = 368,800) were identified.

Results: An IBD diagnosis was associated with a 6- to 7-fold increased risk of CRC (ulcerative colitis, crude odds ratio [OR] = 6.72, 95% CI, 5.79–7.81; Crohn's disease, crude OR = 6.60, 95% CI, 5.56–7.82). Among patients with IBD (364 CRC cases, 1172 controls), exposure to 5-ASA therapy of any dose or duration during the 12 months before CRC diagnosis was not associated with a reduced risk of CRC (OR = 0.97; 95% CI, 0.77–1.23). However, there was a trend toward a decreased risk of CRC with increasing number of mesalamine prescriptions in the previous year, though statistical significance was not achieved (trend P = 0.08).

Conclusions: Treating IBD patients with 5-ASA medications was not found to have a protective effect against colitis-related CRC when assessed over a short period of exposure.

(Inflamm Bowel Dis 2007)

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