Histological differentiation between sporadic and colitis-associated intestinal cancer in a nationwide study: A propensity-score-matched analysis

Motoi Uchino, Hiroki Ikeuchi, Tatsuki Noguchi, Koji Okabayashi, Kitaro Futami, Shinji Tanaka, Hiroki Ohge, Kazuhiro Watanabe, Michio Itabashi, Kinya Okamoto, Yoshiki Okita, Tsunekazu Mizushima, Yusuke Mizuuchi, Kazutaka Yamada, Yoshifumi Shimada, Yu Sato, Hideaki Kimura, Kenichi Takahashi, Koya Hida, Yusuke KinugasaJunji Okuda, Koji Daito, Fumikazu Koyama, Hideki Ueno, Takayuki Yamamoto, Tsunekazu Hanai, Toru Kono, Hirotoshi Kobayashi, Yoichi Ajioka, Kenichi Sugihara, Soichiro Ishihara

Research output: Contribution to journalArticlepeer-review


Background and Aim: Colitis-associated intestinal cancer (CAC) can develop in patients with inflammatory bowel disease; however, the malignant grade of CAC may differ from that of sporadic colorectal cancer (CRC). Therefore, we compared histological findings distinct from cancer stage between CAC and sporadic CRC to evaluate the features of CAC. Methods: We reviewed the clinical and histological data collected from a nationwide database in Japan between 1983 and 2020. Patient characteristics were compared to distinguish ulcerative colitis (UC), Crohn's disease (CD), and sporadic CRC. Comparisons were performed by using all collected data and propensity score-matched data. Results: A total of 1077 patients with UC-CAC, 297 with CD-CAC, and 136 927 with sporadic CRC were included. Although the prevalence of well or moderately differentiated adenocarcinoma (Tub1 and Tub2) decreased according to tumor progression for all diseases (P < 0.01), the prevalence of other histological findings, including signet ring cell carcinoma, mucinous carcinoma, poorly differentiated adenocarcinoma, or squamous cell carcinoma, was significantly higher in CAC than in sporadic CRC. Based on propensity score-matched data for 982 patients with UC and 268 with CD, the prevalence of histological findings other than Tub1 and Tub2 was also significantly higher in those with CAC. At pT4, mucinous carcinoma occurred at a significantly higher rate in patients with CD (45/86 [52.3%]) than in those with sporadic CRC (13/88 [14.8%]) (P < 0.01). Conclusion: CAC, including early-stage CAC, has a higher malignant grade than sporadic CRC, and this difference increases in significance with tumor progression.

Original languageEnglish
Pages (from-to)893-901
Number of pages9
JournalJournal of Gastroenterology and Hepatology (Australia)
Issue number5
Publication statusPublished - 05-2024

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology


Dive into the research topics of 'Histological differentiation between sporadic and colitis-associated intestinal cancer in a nationwide study: A propensity-score-matched analysis'. Together they form a unique fingerprint.

Cite this