Chronic Tophaceous Gout Is a Risk Factor for Colorectal Cancer

Chronic tophaceous gout (CTG) is an independent risk factor for colorectal cancer (CRC), according to study results presented at Digestive Disease Week (DDW), held from May 6 to 9, 2023 in Chicago, Illinois, and virtually.

The findings are based on analysis of data from Explorys Inc, a validated, multicenter and research platform database of more than 360 hospitals from 26 different US health care systems from 1999 to September 2022.

Eligible participants were aged over 18 years. Those with a history of familial adenomatous polyposis, a family history of CRC, and inflammatory bowel disease were excluded.

Multivariate regression analysis was used to calculate the risk for CRC and account for potential cofounders, including male sex, smoking history, alcoholism, obesity, type 2 diabetes, and those diagnosed with CTG. A 2-sided P value less than .05 was considered statistically significant.

Further research is required to assess the prevalence of colon cancer in patients with gout and serum uric acid that is <7 mg/dL.

A total of 70,177,200 individuals were included in the final analysis; 234,840 had CRC and 69,942,360 had no CRC. Type 2 diabetes (28.57% vs 7.90%), smokers (10.98% vs 5.33%), obesity (18.71% vs 7.59%), alcoholism (3.13% vs 1.53%), and patients who have had a diagnosis of CTG (0.08% vs 0.01%) were more common in the CRC group compared with those without CRC, respectively.

According to multivariate regression analysis, the risk for CRC was calculated for the male sex (odds ratio [OR], 1.02; 95% CI, 1.01-1.03), smokers (OR, 1.54; 95% CI, 1.52-1.56), alcoholism (OR, 1.40; 95% CI, 1.37-1.43), obesity (OR, 1.52; 95% CI, 1.50-1.54), type 2 diabetes (OR, 3.53; 95% CI, 3.50-3.57), and a diagnosis of CTG (OR, 1.40; 95% CI, 2.48-3.23).

“Uric acid is likely 1 of the culprits of this association, as it leads to increased production of reactive oxygen species and promotes tumorigenesis,” the researchers wrote. “Further research is required to assess the prevalence of colon cancer in patients with gout and serum uric acid that is <7 mg/dL. This will promote additional discussion about tighter control of serum uric acid levels in this population in order to decrease the overall risk of colon cancer.”


Onwuzo S, Boustany A, Alchirazi KA, et al. Increased risk of colorectal cancer in patients with chronic tophaceous gout: a population-based study. Abstract presented at: DDW 2023; May 6 to 9, 2023; Chicago, IL. Abstract Sa1190.