D0091 - Patients With Eosinophilic Colitis Have Comparable Rates of Colorectal Cancer Compared to Patients With Ulcerative Colitis

Yeseong Kim, MD¹, Fahmi Shibli, MD², Jiasheng Wang, MD³, Woo Jung Jay Lee, MB, BCh, BAO^4
1Temple University Hospital, Philadelphia, PA; ²Emek Medical Center, Institute of Gastroenterology and Hepatology, Afula, HaZafon, Israel; ³University Hospitals Seidman Cancer Center, Cleveland, OH; ⁴Lewis Katz School of Medicine at Temple University, Philadelphia, PA

Introduction: Eosinophilic colitis (EoC) is a rare entity characterized by the presence of high eosinophilic infiltrate into the colonic wall in symptomatic patients, in the absence of known other causes of colonic eosinophilia. Recently proposed guidelines suggest 100 eosinophils per high-power-field in the ascending colon, 85 in the descending, and 65 in the sigmoid colon as diagnostic thresholds. Whereas ulcerative colitis (UC), is known to be associated with an increased risk of colorectal cancer (CRC), little is known of the association between EoC and CRC. We aimed to compare EoC patients to UC patients to assess their odds of developing CRC.

Methods: Using the multi-institutional, health research network database TriNetX (Cambridge, MA), de-identified, aggregated clinical data were obtained on patients with a diagnosis of either EoC or UC. Patients with other identifiable causes of eosinophilia were excluded from the EoC cohort, including inflammatory bowel disease, food allergies, helminth infections, and other eosinophilic gastrointestinal disorders. A 1:1 propensity score matching method was used to stratify EoC and UC patients. Matched variables were age at diagnosis, sex, race, obesity, tobacco abuse, alcohol abuse, and family history of digestive tract malignancy. Odds ratios(OR) and confidence intervals (CI) were calculated for development of CRC and subsequent colonoscopies for each cohort.

Results: A total of 1,310 and 195,477 EoC and UC patients were identified, respectively (Table). The higher proportion of EoC patients were female compared to UC patients (65.4% vs 54.4%), and were African American (11.9% vs 9.2%). More EoC patients reported tobacco usage (4.6% vs 2.5%) and were obese (11.8% vs 7.0%) compared to UC patients. A 1:1 matching ratio stratified 1,310 patients into each cohort. After adjusting for the aforementioned covariates, EoC patients had an OR of 1.304 (95% CI 0.828-2.054, p-value 0.2503) of developing CRC compared to UC patients (Figure). EoC patients demonstrated an OR of 0.754 (95% CI 0.583-0.976, p-value 0.0313) of undergoing subsequent surveillance colonoscopies after initial diagnosis of disease compared to UC patients.

Discussion: Patients with a diagnosis of EoC have a similar risk of developing colorectal cancer compared to UC patients. Despite this, EoC patients are less likely to undergo subsequent surveillance colonoscopy compared to UC patients. Hopefully, our data can be used for future prospective studies investigating the natural course of EoC.




Disclosures:


Yeseong Kim, MD¹, Fahmi Shibli, MD², Jiasheng Wang, MD³, Woo Jung Jay Lee, MB, BCh, BAO⁴. D0091 - Patients With Eosinophilic Colitis Have Comparable Rates of Colorectal Cancer Compared to Patients With Ulcerative Colitis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.