Acute appendicitis among young patients linked to right-side colon cancer
Appendicitis, the most common digestive surgical emergency, has a growing incidence worldwide, with male predilection between 10 and 30 years at the highest risk. Those with acute appendicitis younger than 40 years are at increased risk of colon cancer, particularly in the year following appendicitis with a more marked association for right-side colon cancer, says Manon Viennet said in a study published in eClinicalMedicine. They also found eight times greater risk within the first six months in appendicitis patients compared to controls.
Colorectal cancer is the third most common in France, while acute appendicitis is a common digestive disease requiring emergency surgery. Researchers say that the risk of colorectal cancer is increased after acute appendicitis. In the present study, a team of researchers assessed the frequency of hospitalization for colon cancer after appendicitis in a nationwide analysis.
French Hospital Discharge Database was used in this study and included all 230,349 patients aged 18–59 years presenting with acute appendicitis between 2010 and 2015. Univariate and multivariate analyses were performed.
Study results could be interpreted as:
- There were 200,000 patients in the appendicitis group, and more than 400,000 matched controls without appendicitis.
- There were more cases of colon cancer in the appendicitis group, especially during the first year after appendicitis (5 per 10,000 vs. 1 per 10,000).
- Those treated for appendicitis had a four times higher risk of a colon cancer diagnosis than controls during the first year of follow-up with sHR of 4.67.
- The risk was eight times higher during the first six months, with an sHR of 8.39.
- The association was more marked for right-sided colon cancer.
- Colon cancer diagnosis was greater in patients under 40 years, with a 6-fold and 12-fold increased risk.
Researchers interpreted acute appendicitis as a warning sign for colon cancer in middle-aged and younger adults.
Within the first year after acute appendicitis, colon cancer risk is higher than in the population without acute appendicitis, with more marked association for right-sided colon cancer.
They reported the risk of colon cancer higher during the first six months after acute appendicitis.
The Regional Council of Burgundy funded the study.
Further reading:
Viennet M, Tapia S, Cottenet J, Bernard A, Ortega-Deballon P, Quantin C. Increased risk of colon cancer after acute appendicitis: a nationwide, population-based study. EClinicalMedicine. 2023 Aug 30;63:102196. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10480545/
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