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Risk of Anorectal Cancer Associated with Benign Anal Inflammatory Diseases: A Retrospective Matched Cohort Study

Authors
 Wonjeong Chae  ;  Seung Yeon Kang  ;  Sung-In Jang  ;  Yoon Dae Han 
Citation
 INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol.19(12) : 7467, 2022-06 
Journal Title
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
ISSN
 1661-7827 
Issue Date
2022-06
MeSH
Anus Diseases* / complications ; Anus Diseases* / diagnosis ; Anus Diseases* / epidemiology ; Anus Neoplasms* / epidemiology ; Cohort Studies ; Gastrointestinal Neoplasms* / complications ; Humans ; Inflammatory Bowel Diseases* / complications ; Inflammatory Bowel Diseases* / epidemiology ; Rectal Neoplasms* / epidemiology ; Retrospective Studies
Keywords
anal fissure ; anal fistula ; anorectal cancer ; benign anal inflammatory diseases
Abstract
Purpose: The purpose of our study was to evaluate the relationship between benign anal inflammatory diseases and anorectal cancer and assess its risk factors.

Methods: A retrospective matched cohort study was conducted that included data from 2002 to 2013. The National Health Insurance Service National Sample Cohort data from 2002 to 2013 was used for the study. Of a total study population of 143,884 individuals, 28,110 individuals with anal fissures were assigned to the case group, while 115,774 individuals without anal fissures were assigned to the control group based on the 1:4 propensity score matching age, sex, and year (case: diagnosed year, control: health service received year).

Results: The risk of anorectal cancer was higher in the case group (hazard ratio [HR]: 1.95, 95% confidence interval [CI]: 1.51-2.53) compared to the control group. After grouping anorectal cancers into anal cancer and rectal cancer, the risk remained higher in the case group (anal cancer HR: 2.79, 95% CI: 1.48-5.27; rectal cancer HR: 1.82, 95% CI; 1.37-2.42). The case group was further categorized into patients with fissures and patients with fistulas; patients with fissures showed a higher risk of developing anorectal cancer than patients with fistulas (HR: 2.05, 95% CI: 1.53-2.73 vs. HR: 1.73, 95% CI: 1.13-2.66). Study participants in their 30s and 40s had a 4.19- and 7.39-times higher risk of anorectal cancer compared to those in the higher age groups (0.64-1.84), while patients who did not have inflammatory bowel disease (IBD) had a higher risk of developing anorectal cancer (HR: 2.09, 95% CI: 1.56-2.80).

Conclusions and relevance: Patients with anal fistulas or fissures have an increased risk of being diagnosed with anorectal cancer, especially at a young age and even without IBD.
Files in This Item:
T202203704.pdf Download
DOI
10.3390/ijerph19127467
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Jang, Sung In(장성인) ORCID logo https://orcid.org/0000-0002-0760-2878
Chae, Wonjeong(채원정)
Han, Yoon Dae(한윤대) ORCID logo https://orcid.org/0000-0002-2136-3578
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191561
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