Relationship between appendicitis and colon cancer

relationship between appendicitis and colon cancer

The association between appendicitis and colon cancer has not been sufficiently investigated, and this study was designed to clarify this association. Colorectal cancer (CRC) rates in New Zealand are among the there was a difference in the rate of diagnosis of colorectal carcinoma for. Carcinoma of the colon, besides causing acute appendicitis, may cause symptoms resembling appendicitis. A diagnosis of appendicitis was made when .

[Acute appendicitis or colon cancer? Difference in elderly patients not always clear].

We investigated whether appendectomy alters colorectal cancer risk. Methods We identified a cohort of patients who underwent appendectomy between and based on the insurance claims of Taiwan. A comparison cohort of persons without appendectomy was selected randomly, frequency matched by age, sex, comorbidity and entry year was also selected.

We monitored subsequent colorectal cancer development in both cohorts. Men were at higher risk than women.

The incidence of colorectal cancer was much higher in 1. Patients who received an incidental appendectomy had an HR of 2. Conclusions Results of our study suggest that appendectomy in patients with appendicitis is likely associated with the development of colorectal cancer in the post-surgery period.

relationship between appendicitis and colon cancer

Introduction Colorectal cancer is a common cancer that results in more thandeaths globally each year. Recent studies have found that up-regulated Interleukin, Interleukin and signal transducer and activator of transcription STAT 3 play an important role in driving tumor growth in patients with intestinal inflammation.

The microbiota and biofilm in the large bowel might be changed after removal of the appendix i. However, despite variation in CRC rates throughout New Zealand, the Bay of Plenty has an age-standardised rate equivalent to national rates, and the results of this study should therefore be comparable to those of the general population.

However, the results are similar to and supported by other studies in this area. Also, patients were included in this study up until Januaryand consequently some patients had only a short period of follow-up. If anything, this would minimise the findings of this study as it may have missed a CRC diagnosis for these patients during the subsequent follow-up period. It is also important to emphasise that given this is a retrospective non-randomised study the difference in CRC demonstrated in this population group could be due to a number of underlying factors that cannot be controlled for in this study design.

[Acute appendicitis or colon cancer? Difference in elderly patients not always clear].

However, this study is unique in that it standardised for age, gender and ethnicity, and therefore these attributing factors should be minimised. The findings of this study support the hypothesis that appendicitis is associated with an increased rate of underlying colorectal malignancy and may be a sign of an undiagnosed colorectal cancer.

All patients diagnosed with colorectal cancer as a result of their initial histology warrant completion colonoscopy prior to definitive surgical intervention. In those whom the histology from appendicectomy was benign, colonic investigation is more controversial. Three patients were ultimately diagnosed with CRC due to classic symptoms attributed to bowel cancer; large bowel obstruction, PR bleeding and change in bowel habit six, 12 and 28 months later respectively.

After excluding those diagnosed on initial histology, there remained a three-fold increased SR 1.

Screening for Colorectal Cancer

Given the numbers are small within this population group, it is difficult to make any definitive conclusions. The association of distal CRC attributing to appendicitis could be theoretically explained by either distal partial colonic obstruction or immune-mediated lymphoid hyperplasia within the appendix, however, with small study numbers susceptible to type two error it would be a bold statement to recommend universal colonic investigation for these patients until further prospective studies are completed.

This is the first study of its kind conducted in Australasia. The study reinforces the limited evidence that appendicitis is associated with increased risk of underlying CRC in middle-aged and older adult patients.

relationship between appendicitis and colon cancer

If a patient is managed non-operatively or the histology of the initial specimen reveals malignancy, these patients should all be offered colonic investigation. One was diagnosed one month later on follow-up colonoscopy and the other was diagnosed 28 months later because they had abdominal pain. The remaining five patients were detected a median of 12 months later suggesting these cancers were also present at the time of appendicitis. The study author concluded the possibility of a co-existent cancer should always be kept in mind when treating patients over 45 who had symptoms of appendicitis and said clinicians should pay particular attention to any factors that may raise the suspicion of colorectal cancer.

relationship between appendicitis and colon cancer

The authors stopped short of recommending universal colonic investigation for these patients but said if a person's appendicitis was treated without operating or if their initial tissue specimen revealed malignancy they should be offered it. Even if tissue samples were benign, doctors should consider whether colonic investigation might be worthwhile, they said. The study comes as the government begins the roll-out of the national bowel screening programme, piloted by Waitemata District Health Board.