TY - JOUR

T1 - The Incidence and Disease Course of Perianal Crohn's Disease

T2 - A Danish Nationwide Cohort Study, 1997-2015

AU - Wewer, M D

AU - Zhao, M

AU - Nordholm-Carstensen, A.

AU - Weimers, P

AU - Seidelin, J B

AU - Burisch, J

N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.

PY - 2021

Y1 - 2021

N2 - BACKGROUND AND AIMS: Perianal Crohn's disease (CD) places a considerable burden on patients' quality of life and is complex to treat. Despite its impact and high frequency, few studies have investigated the incidence and disease course of perianal CD. The aim of this study was to assess the incidence and disease course of perianal CD in adult patients throughout a 19-year period.METHODS: The cohort comprised all individuals aged 18 years or older who were diagnosed with CD in Denmark between January 1st, 1997 and December 31st, 2015, according to the National Patient Registry (NPR).RESULTS: A total of 1,812 out of 9,739 (19%) patients with CD were found to have perianal CD. Perianal fistulas were the most common manifestation, accounting for 943 (52%) cases. The incidence of perianal CD remained stable over time. Patients with perianal CD were found to have an increased risk of undergoing major abdominal surgery compared to patients without perianal CD (hazard ratio: 1.51, 95% CI: 1.40 to 1.64, p<0.001) in a multivariate Cox regression analysis. The incidence rate ratios of anal and rectal cancer in perianal CD patients were 11.45 (95% CI: 4.70 to 27.91, p<0.001) and 2.29 (95% CI: 1.25 to 4.20, p=0.006), respectively, as compared to non-IBD matched controls.CONCLUSIONS: In this nationwide study, 19% of CD patients developed perianal disease. Patients with perianal CD were at increased risk of undergoing major surgery compared to non-perianal CD patients. The risk of anal and rectal cancer was increased in patients with perianal CD compared to non-IBD matched controls.

AB - BACKGROUND AND AIMS: Perianal Crohn's disease (CD) places a considerable burden on patients' quality of life and is complex to treat. Despite its impact and high frequency, few studies have investigated the incidence and disease course of perianal CD. The aim of this study was to assess the incidence and disease course of perianal CD in adult patients throughout a 19-year period.METHODS: The cohort comprised all individuals aged 18 years or older who were diagnosed with CD in Denmark between January 1st, 1997 and December 31st, 2015, according to the National Patient Registry (NPR).RESULTS: A total of 1,812 out of 9,739 (19%) patients with CD were found to have perianal CD. Perianal fistulas were the most common manifestation, accounting for 943 (52%) cases. The incidence of perianal CD remained stable over time. Patients with perianal CD were found to have an increased risk of undergoing major abdominal surgery compared to patients without perianal CD (hazard ratio: 1.51, 95% CI: 1.40 to 1.64, p<0.001) in a multivariate Cox regression analysis. The incidence rate ratios of anal and rectal cancer in perianal CD patients were 11.45 (95% CI: 4.70 to 27.91, p<0.001) and 2.29 (95% CI: 1.25 to 4.20, p=0.006), respectively, as compared to non-IBD matched controls.CONCLUSIONS: In this nationwide study, 19% of CD patients developed perianal disease. Patients with perianal CD were at increased risk of undergoing major surgery compared to non-perianal CD patients. The risk of anal and rectal cancer was increased in patients with perianal CD compared to non-IBD matched controls.

U2 - 10.1093/ecco-jcc/jjaa118

DO - 10.1093/ecco-jcc/jjaa118

M3 - Journal article

C2 - 32582937

VL - 15

SP - 5

EP - 13

JO - Journal of Crohn's and Colitis

JF - Journal of Crohn's and Colitis

SN - 1873-9946

IS - 1

ER -