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ARTICLE TYPE : RESEARCH ARTICLE

Published on :   03 Dec 2025, Volume - 1
Journal Title :   WebLog Journal of Gastroenterology | WebLog J Gastroenterol
Source URL:   weblog iconhttps://weblogoa.com/articles/wjg.2025.l0301
Permanent Identifier (DOI) :  doi iconhttps://doi.org/10.5281/zenodo.17863709

Colorectal Cancer Risk in Crohn’s Disease Patients After Colectomy: A Propensity-Matched Cohort Study Using a Nationwide EMR Database

Syed Fahad Gillani 1 *
Rawan Elkomi 1
Anand Deonarine 1
Syed Asad Geelani 4
Ali Chand 1
Jesse Maynard 2
Mekdem Bisrat 1
Miriam Michael 1,3
1Department of Internal Medicine, Howard University, Washington, DC, USA
2College of Medicine, Howard University, Washington, DC, USA
3Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, USA
4Deaprtment of Gastroenterology, University Hospitals of Leicester, Leicester, United Kingdom

Abstract

Objective: To assess the risk of colorectal malignancy in CD patients with and without colectomy over time.

Methods: A retrospective cohort study was conducted using the TriNetX Research Network, which includes data from 70 U.S. healthcare organizations. A total of 7,315 CD patients who underwent partial or total colectomy were matched 1:1 to 7,315 patients without surgical intervention. Patients with ulcerative colitis were excluded. CRC outcomes including colon (C18), rectosigmoid (C19), and rectal (C20) cancers were analyzed at 5-, 10-, and 20-year follow-up intervals. Hazard ratios (HR) with 95% confidence intervals (CI) were calculated, and Kaplan-Meier curves were compared using log-rank testing.

Results: Among 14,630 matched CD patients, colon cancer incidence at 5 years was 5.4% in the colectomy group vs. 0.6% in the non-colectomy group (HR 8.40; 95% CI: 6.19 to 11.40). Elevated risk persisted at 10 years (5.5% vs. 0.8%; HR 7.02) and 20 years (6.1% vs. 0.9%; HR 7.06). Rectosigmoid cancer occurred in 1.5% of colectomy patients vs. 0.2% of controls (HR 7.09), and rectal cancer in 1.5% vs. 0.5% (HR 3.23). All differences were statistically and clinically significant.

Conclusions: Colectomy in CD is associated with a sustained increase in CRC risk, especially in the colon and rectosigmoid junction, highlighting the need for lifelong surveillance in this population.

Keywords: Crohn’s Disease; Colectomy; Colorectal Cancer; Inflammatory Bowel Disease

Citation

Gillani SF, Elkomi R, Deonarine A, Geelani SA, Chand A, Maynard J, et al. Colorectal Cancer Risk in Crohn’s Disease Patients After Colectomy: A Propensity-Matched Cohort Study Using a Nationwide EMR Database. WebLog J Gastroenterol. wjg.2025. l0301. https://doi.org/10.5281/zenodo.17863709
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