S436 Is the Rising Incidence of Colorectal Neuroendocrine Tumors Masking Persistent Mortality Disparities?
Abstract
Introduction: Microscopic colitis (MC) is increasing in incidence worldwide. While its etiology remains unclear, an association with various medications has been suggested, though large-scale data are limited. We aimed to determine the risk of MC in patients exposed to specific drugs within a large, multi-institutional healthcare database. Methods: We conducted a retrospective cohort study using the TriNetX research network. Patients aged >18 years with no prior history of MC or inflammatory bowel disease undergoing colonoscopy with biopsy were included and divided into cohorts based on exposure to drugs of interest within 3 months prior to procedure. Control cohorts comprised patients with no prior exposure to the studied drug. After crude analysis, unexposed cohorts were propensity score-matched for age, gender, race, smoking status, and alcohol use for a propensity matched analysis. Primary outcome was diagnosis of MC following procedure. Results: A total of 1,234,310 patients undergoing colonoscopy with biopsy were analyzed across the cohorts. Among major drug classes, selective serotonin reuptake inhibitors (SSRIs; RR 1.40 [1.31-1.51]) and nonsteroidal anti-inflammatory drug (NSAIDs; RR 1.05 [1.01-1.11]) were noted to be significantly associated with increased risk of MC diagnosis. Highest risk among SSRIs was noted with sertraline (RR 1.58 [1.39-1.79]) while diclofenac was noted to have the highest risk among NSAIDs (RR 1.61 [1.41-1.84]). As a class, proton pump…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,234,310 participants or records.
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