Patients with primary biliary cholangitis (PBC) may have an increased risk of developing colon polyps or colorectal cancer, according to a study recently published in the Journal of the Formosan Medical Association. A colon polyp is a non-cancerous tissue growth projecting from the lining of the large intestine.
PBC is associated with the dysregulation of the liver enzymes, which can influence the health of the colon. Anatomically, the liver and the colon are situated next to each other and are linked together via the biliary system.
Taiwanese researchers sought to clarify the role of PBC in causing colon-related illnesses such as polyps and cancer. To do so, they retrieved data from a large health insurance database that consisted of 2 million patients between 2000 and 2017.
In total, the research team looked into the clinical data of 2,024 patients who were diagnosed with PBC, the majority (74.75%) of whom were female. In addition, the research team placed 8,096 individuals in the comparison cohort, which translated into a ratio of four healthy individuals for every one patient with PBC. Individuals in the comparison cohort were not diagnosed with PBC during the study period.
Read more about PBC testing and diagnosis
A detailed statistical analysis of the data provided found that patients with PBC had a 1.68-fold increased risk of developing colon polyps and colorectal cancer compared with the comparison cohort. Among the 2,024 patients with PBC, 199 patients (9.8%) were found to have developed colon polyps or colorectal cancer during the study period. In contrast, among the 8,096 individuals in the comparison cohort, only 650 cases of colon polyps or colorectal cancer were recorded (8%).
The findings of this study raise more questions regarding the relationship between the liver and the colon. Specifically, this study uncovers gaps in our understanding with regards to the influence of PBC, bile acids, ursodeoxycholic acid (the primary treatment for PBC) and the risk of developing colon polyps or colorectal cancer.
“These findings suggest a potential association between PBC and colonic neoplasia [ie, cancer], warranting further investigation into the role of endoscopic evaluation in patients with PBC,” the investigators concluded. “Additional research, particularly prospective studies, is needed to confirm these observations.”
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