Veterans Diagnosed with Pyogenic Liver Abscess Have Significantly Higher Rates of Colorectal Cancer for Up to Three Years after PLA Diagnosis
BACKGROUND:
Colorectal cancer (CRC) is a common and potentially life-threatening disease. Preliminary data suggest that patients with pyogenic liver abscess (PLA) have higher CRC incidence rates, but data from outside the Southeast Asian population is sparse. This retrospective study investigated the association between PLA and the subsequent incidence of diagnosed CRC among 8,286 Veterans (97% male, mean age 66) diagnosed with PLA and admitted to one of 127 VA hospitals nationwide from January 2003 through December 2020. Researchers compared the outcomes of Veterans diagnosed with PLA against 23,201 Veterans who had not been diagnosed with PLA but matched the PLA-diagnosed Veterans in age, sex, and healthcare facility. The primary outcome was CRC diagnosis during a follow-up period of up to 10 years.
FINDINGS:
- CRC diagnosis was found in a significantly higher proportion of Veterans with PLA compared to controls (2% vs. 1%).
- The incidence of CRC was significantly higher among Veterans with PLA during the first three years from PLA diagnosis, but not significant after three years.
- The association was not observed among Veterans whose PLA was likely secondary to cholangitis or cholecystitis (non-cryptogenic PLA).
IMPLICATIONS:
- Considering the worse outcome of CRC associated with PLA, clinicians should be aware of the association between cryptogenic PLA and CRC and should offer CRC screening for Veterans with cryptogenic PLA, especially for those who have not been screened according to guidelines.
LIMITATIONS:
- Researchers were not able to control for important risk factors such as smoking or family history of CRC.
- Researchers were not able to capture CRC diagnosis made outside the VHA system.
- Researchers were not able to assess important information such as methods of CRC screening or stage of CRC at the time of diagnosis.
AUTHOR/FUNDING INFORMATION:
Drs. Suzuki, Tanaka, and Goto are with HSR&D’s Center for Access & Delivery Research and Evaluation (CADRE) in Iowa.
Suzuki H, Kidder I, Tanaka T, Goto M. Incidence of Colorectal Cancer in Patients Diagnosed with Pyogenic Liver Abscess. JAMA Network Open. December 18, 2023; 6(12):e2348218.
