{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T13:21:10Z","timestamp":1789651270191,"version":"4.0.0"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001732","name":"Danmarks Grundforskningsfond","doi-asserted-by":"publisher","award":["DNRF148"],"award-info":[{"award-number":["DNRF148"]}],"id":[{"id":"10.13039\/501100001732","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Patients with Crohn's disease (CD) often suffer from perianal fistulizing disease. Their risk of anorectal cancer remains uncertain. We aimed to examine the long\u2010term risk of anorectal cancer in a population\u2010based cohort of CD patients with anorectal fistula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Our study population covered all individuals (<jats:italic>n<\/jats:italic>\u2009=\u20097\u2009987\u2009520) aged 15+ years living in Denmark from 1978 to 2018. We identified all patients with CD and anorectal fistula in the Danish National Patient Register (NPR) and 50 matched noninflammatory bowel disease (IBD) individuals from the general population. Using Cox regression analyses, we examined the risk of anorectal cancer in CD fistula patients versus non\u2010IBD individuals. All patients with CD were identified using codes from the International Classification of Diseases and their data extracted from the NPR. The main outcome measure was cases of anorectal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2786 CD patients with anorectal fistula and 139\u2009300 non\u2010IBD individuals were followed for 1\u2009553\u2009917 person\u2010years. During follow\u2010up, anorectal cancer was observed in 19 CD patients (0.68%) and 340 non\u2010IBD individuals (0.24%), corresponding to a 2.9\u2010fold increased hazard ratio (HR) of anorectal cancer in CD fistula patients (95% CI 1.80\u20134.53), with a particularly high risk of anal cancer (HR 15.13, 95% CI 6.88\u201333.31) and a mean time from CD fistula diagnosis to anorectal cancer of 6.7 (SD 6.5) years. The risk was slightly higher in women than men and had no apparent relation to treatment with tumour necrosis factor\u2010\u03b1 inhibitors. Sensitivity analyses using CD nonfistula patients for comparison revealed similar results. Individual data on smoking and infection with human papilloma virus were not available.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with CD and anorectal fistula have a three\u2010fold increased risk of anorectal cancer compared with the general population. The number needed to surveil to detect one case of anorectal cancer in this patient population was 2160 patients per year in patients with long\u2010standing fistula (&gt;6\u2009years).<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16581","type":"journal-article","created":{"date-parts":[[2023,4,22]],"date-time":"2023-04-22T05:49:38Z","timestamp":1682142578000},"page":"1453-1459","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Risk of anorectal cancer in patients with Crohn's disease and perianal fistula: a nationwide Danish cohort study"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0070-8362","authenticated-orcid":false,"given":"Alaa","family":"El\u2010Hussuna","sequence":"first","affiliation":[{"name":"Department of Gastro\u2010Intestinal Surgery Aalborg University Hospital  Aalborg Denmark"},{"name":"OpenSourceResearch Collaboration (www.osrc.network)  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0405-0035","authenticated-orcid":false,"given":"Camilla Engel","family":"Lemser","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine National Center of Excellence for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, Aalborg University  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7096-1144","authenticated-orcid":false,"given":"Aske Thorn","family":"Iversen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine National Center of Excellence for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, Aalborg University  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6880-5759","authenticated-orcid":false,"given":"Kristine H\u00f8jgaard","family":"Allin","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine National Center of Excellence for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, Aalborg University  Copenhagen Denmark"},{"name":"Department of Gastroenterology and Hepatology Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4391-7332","authenticated-orcid":false,"given":"Tine","family":"Jess","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine National Center of Excellence for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, Aalborg University  Copenhagen Denmark"},{"name":"Department of Gastroenterology and Hepatology Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(17)32448\u20100"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2015.04.013"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000700"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.00287.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.12.037"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.05.019"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.5613"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02237388"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjx035"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2012.09.015"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474124.2018.1500175"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v2.i7.307"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjaa118"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21228"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.11.041"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e32836371a2"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379\u2010018\u20100105\u20108"},{"key":"e_1_2_10_19_1","first-page":"685","article-title":"Adenocarcinoma associated with perianal fistulas in Crohn's disease","volume":"33","author":"Ogawa H","year":"2013","journal-title":"Anticancer Res."},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3393\/ac.2021.02.08"}],"container-title":["Colorectal 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