急性阑尾炎是最常见需要紧急手术治疗的消化系统疾病。结直肠癌是法国第三常见的癌症。有研究表明，急性阑尾炎后患结直肠癌的风险增加。本研究旨在通过全国范围分析评估急性阑尾炎后结肠癌住院频率。使用法国住院者出院数据库（PMSI），纳入2010年至2015年之间年龄为18-59岁的所有急性阑尾炎患者。进行单变量和多变量分析，将这些患者与同一时期因创伤住院的对照群体进行比较。排除具有结直肠癌强风险因素的患者。共纳入230,349例急性阑尾炎患者（曝露组）。使用倾向评分将每个曝露患者与两个未曝露患者（对照组）进行配对，以确保两组的可比性，最终形成一个由460,698例患者组成的对照组。单变量分析发现，阑尾炎组结肠癌发生率显著增加，尤其是在阑尾炎后的第一年（每1万人中5例对比1例，p < 0.000，阑尾炎组111例），特别是在前6个月。生存分析证实，在随访的第一年内，接受阑尾炎治疗的患者被诊断为结肠癌的风险比对照组高4倍（sHR = 4.67；95％CI：3.51-6.21），在前6个月内风险提高8倍（sHR = 8.39；95％CI：5.41-12.99）。该关联在右侧结肠癌中更为显著（sHR = 8.25；95％CI：5.03-13.54，在第一年内）。尽管40岁以上患者的结肠癌诊断风险也存在显著性，但对40岁以下患者而言，风险增加6到12倍。在这个基于人群的研究中，我们发现急性阑尾炎似乎是中年和年轻成年人结肠癌的一个预警信号（逆因果关系）。急性阑尾炎后出现结肠癌的风险在初次六个月内更高。这引发了关于成年人急性阑尾炎常规诊断工作的问题。Burgundy地区委员会。© 2023 作者。

Acute appendicitis is the most common digestive disease requiring emergency surgery. Colorectal cancer is the third most common cancer in France. An increased risk of colorectal cancer after acute appendicitis has been suggested. We aimed to assess the frequency of hospitalization for colon cancer after appendicitis in a nationwide analysis.Using the French Hospital Discharge Database (PMSI), we included all patients aged 18-59 years presenting with acute appendicitis between 2010 and 2015. Univariate and multivariate analyses were performed to compare colon cancer occurrence in these patients vs a control-matched population with a hospital stay for trauma in the same period. Patients presenting strong risk factors for colorectal cancer were excluded.A total of 230,349 patients with acute appendicitis (exposed group) were included. We used a propensity score to match each exposed patient with two unexposed patients (controls) to ensure the comparability of the groups, resulting in a control group of 460,698 patients. Univariate analysis found significantly more colon cancer in the appendicitis group, especially during the first year after appendicitis (5 per 10,000 vs 1 per 10,000, p < 0.000, this corresponds to 111 patients in the appendicitis group), namely within the first 6 months. Survival analysis confirmed patients treated for appendicitis present a 4 times higher risk of being diagnosed with colon cancer than control patients during the first year of follow-up (sHR = 4.67 (95% CI: 3.51-6.21), and 8 times higher during the first 6 months (sHR = 8.39; 95% CI: 5.41-12.99). The association was even more marked for right-sided colon cancer (sHR = 8.25; 95% CI: 5.03-13.54 during the 1st year). While the risk of diagnosis of colon cancer was also significant for patients over 40 years, it was even greater in patients under 40 years, who had between a 6-fold and 12-fold increase in risk.In this population-based study, we found that acute appendicitis seems to be a warning sign for colon cancer (reverse causality) in both middle-aged and younger adults. The risk of presenting with cancer colon was higher during the first six months after acute appendicitis. This raises the issue of routine diagnostic work-up in adults presenting with acute appendicitis.Regional Council of Burgundy.© 2023 The Author(s).