Colon cancer risk quadruples within 1 year of appendicitis onset

The research covered in this overview includes: ssrn.com Published as a preprint and has not yet been peer-reviewed.

Important points

why is this important

• Previous reports linking appendicitis and colon cancer were mostly based on single-center series limited to people over 40 years of age.

• A new study documents virtually all cases of appendicitis in young and middle-aged adults in France from 2010 to 2015.

• Given the short interval between appendicitis and cancer diagnosis, this study suggests that appendicitis is an early warning sign of colon cancer rather than a cause of it.

• This finding supports routine colon cancer screening for adult patients with appendicitis.

research design

• Researchers used the French Hospital Discharge Database to match 230,512 cases of acute appendicitis in adults aged 18 to 59 years with 461,024 control patients hospitalized for trauma between 2010 and 2015 in a 1:2 ratio. . Case patients and controls were matched for age, gender, and comorbidity index.

• The research team compared the subsequent incidence of colon cancer between the two groups.

• Participants with a personal or family history of colon cancer and other strong risk factors were excluded.

• Patients diagnosed with colon cancer within 1 month after appendicitis onset were excluded to exclude cases diagnosed during appendicitis onset. appendectomy.

Main results

• Overall, 111 patients were diagnosed with colon cancer within 1 year of having appendicitis or undergoing appendectomy for treatment of appendicitis. There were 55 people in the control group (P < .0001).

• After adjusting for confounders, the risk of colon cancer was almost four times higher in patients treated for appendicitis than in controls during the first year of follow-up (adjusted hazard ratio) [aHR], 3.93). Almost 6x increase in first 6 months (aHR, 5.92).

• People with appendicitis under the age of 40 were about six times more likely to develop colon cancer within a year.

• Appendicitis was associated with a higher risk of developing colon cancer within 1 year obesity patients (aHR, 19.67) and non-obese patients (aHR, 3.67).

• This association was particularly strong in the first year for right-sided colon cancers on the same side as the appendix (aHR, 8.21).

• After 1 year, the incidence of colon cancer was similar in both groups.

Limitations

• There was no information about how the colon cancer was discovered after appendicitis, and no information was available about the staging of the tumor.

• Lifestyle factors that increase the risk of colon cancer were also not included in the dataset.

disclosure

This is a summary of the preprint research study “Increased risk of colon cancer after acute appendicitis: a national population-based study” led by Manon Viennet of the University of Dijon, France, provided by Medscape. This study has not been peer-reviewed. The full text is available at: ssrn.com.

M. Alexander Otto is a physician assistant who earned a master’s degree in medicine and a degree in journalism from Newhouse. He is an award-winning medical journalist who worked for several major news organizations before joining Medscape, and is also an MIT Knight of the Science of Journalism Fellow. Email: aotto@mdedge.com.

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