Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Jun 24, 2024; 15(3): 93408
Published online Jun 24, 2024. doi: 10.4291/wjgp.v15.i3.93408
Link between irritable bowel syndrome, depression, and colorectal cancer risk in young patients: Age-matched nationwide population-based study
Sai Priyanka Mellacheruvu, Sai Prasanna Lekkala, Sukhjinder Chauhan, Adil Sarvar Mohammed, Sravya R Mundla, Ankita Shenoy, Bilal Khan Mohammed, Jerrin Bawa, Shantha Nallapothula, Priyatham Gurram, Akhil Jain, Rupak Desai, Mohammed Mustafa Nayeem
Sai Priyanka Mellacheruvu, Department of Public Health, University of Massachusetts, Lowell, MA 01854, United States
Sai Prasanna Lekkala, Department of Internal Medicine, Mamata Medical College, Telangana, Khammam 507002, India
Sukhjinder Chauhan, Department of Internal Medicine, Mountainview Hospital, Las Vegas, NV 89128, United States
Adil Sarvar Mohammed, Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI 48602, United States
Sravya R Mundla, Department of Public Health, Apollo Institute of Medical Sciences and Research, Telangana, Hyderabad 500090, India
Ankita Shenoy, Department of Medicine, Dr D.Y.Patil University School of Medicine, Maharashtra, Navi Mumbai 400706, India
Bilal Khan Mohammed, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
Jerrin Bawa, Department of Internal Medicine, Flushing Hospital Medical Center, Queens, NY 11355, United States
Shantha Nallapothula, Department of Internal Medicine, PES Institute of Medical Sciences and Research, Andhra Pradesh, Kuppam 517425, India
Priyatham Gurram, Department of Gastroenterology, Mayo Clinic, Scottsdale, AZ 85259, United States
Akhil Jain, Division of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77079, United States
Rupak Desai, Independent Researcher, Atlanta, GA 30079, United States
Mohammed Mustafa Nayeem, Department of Internal Medicine, Parkview Medical Center, Pueblo, CO 81003, United States
Author contributions: Desai R and Lekkala SP designed the research study; Mellacheruvu SP, Chauhan S, Mohammed AS, Mundla SR, Shenoy A, Lekkala SP and Desai R performed the research; Mohammad BK, Bawa J, Nallapothula S and Gurram P analyzed the data and wrote the manuscript; Jain A, Nayeem MM, Desai R reviewed and edited the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: Since the data included in this review were de identified and already available in the publicly accessible databases, the IRB review was not mandatory. This review was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent statement: No written consent has been obtained from the patients as there is no patient-identifiable data included in this observational study from the National Inpatient Sample database.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sai Prasanna Lekkala, MBBS, Chief Doctor, Department of Internal Medicine, Mamata Medical College, Police Housing Colony, Opp, Mamata Medical College Rd, Netaji Nagar, Rotary Nagar, Telangana, Khammam 507002, India. lekkala.saiprasanna@gmail.com
Received: February 28, 2024
Revised: May 13, 2024
Accepted: June 3, 2024
Published online: June 24, 2024
Processing time: 113 Days and 16.6 Hours
Abstract
BACKGROUND

There exists a link between irritable bowel syndrome (IBS) and depression. Similarly, chronic depression is known to increase the risk of cancer in general. In this population-based analysis, we investigated the prevalence and the odds of colorectal cancer (CRC) in young-depressed patients with IBS.

AIM

To investigate the relationship between IBS and CRC in young, depressed patients using a nationally representative United States inpatient sample.

METHODS

The 2019 National Inpatient Sample was used to identify young (18-44 years) patients admitted with comorbid depression in the presence vs absence of IBS using relevant International Classification of Diseases, Tenth Revision, Clinical Modification codes. Primary endpoint was the prevalence and odds of CRC in age matched (1:1) young-depressed cohort hospitalized with IBS (IBS+) vs without IBS (IBS-). Multivariable regression analysis was performed adjusting for potential confounders.

RESULTS

Age-matched (1:1) young-depressed IBS+ (83.9% females, median age 36 years) and IBS- (65.8% females, median age 36 years) cohorts consisted of 14370 patients in each group. IBS+ cohort had higher rates of hypertension, uncomplicated diabetes, hyperlipidemia, obesity, peripheral vascular disease, chronic obstructive pulmonary disease, hypothyroidism, prior stroke, prior venous thromboembolism, anxiety, bipolar disorder, and borderline personality disorder (P < 0.005) vs the IBS- cohort. However, prior myocardial infarction, acquired immunodeficiency syndrome, dementia, smoking, alcohol abuse, and drug abuse (P < 0.005) are high in IBS- cohort. The rate of CRC was comparable in both cohorts [IBS+ n = 25 (0.17%) vs IBS- n = 35 (0.24%)]. Compared to the IBS- cohort, the odds ratio (OR) of developing CRC was not significantly higher [OR 0.71, 95% confidence interval (CI) 0.23-2.25)] in IBS+ cohort. Also, adjusting for baseline sociodemographic and hospital characteristics and relevant comorbidities, the OR was found to be non-significant (OR 0.89, 95%CI 0.21-3.83).

CONCLUSION

This nationwide propensity-matched analysis revealed comparable prevalence and risk of CRC in young-depressed patients with vs without IBS. Future large-scale prospective studies are needed to evaluate the long-term effects of depression and its treatment on CRC risk and outcomes in IBS patients.

Keywords: Colorectal cancer; Depression; Irritable bowel syndrome; Young patients; National inpatient sample; Comorbidities

Core Tip: Young adults with depression and irritable bowel syndrome (IBS) do not have a significantly higher risk of colorectal cancer (CRC) compared to those without IBS. Further prospective studies are required to understand the long-term effects of depression and its treatment on CRC risk in IBS patients.