Gout and Colorectal Cancer Likelihood: Insights from a Nested Case-Control Study of the Korean Population Utilizing the Korean National Health Insurance Service-National Sample Cohort

Simple Summary Using Korean National Health Insurance Service-National Sample Cohort database, we studied whether patient-specific factors such as age, gender, socioeconomic status, and presence of comorbidities may influence the relationship between gout and the likelihood of developing CRC. Our nested case-control study with propensity score overlap-weighted multivariate logistic regression analyses suggest that patients with gout are not at higher risk for CRC than a control group, indicating that gout may not significantly and independently contribute to the CRC risk of the general population. Nevertheless, within a specific subgroup of patients aged less than 65 years, there appeared to be a moderately reduced probability of CRC development. Further comprehensive research is necessary to substantiate this association and gain a better understanding of the underlying causal factors.Abstract Considering the global importance of both gout and colorectal cancer (CRC) as significant health issues with mutual relevance, we aimed to examine the risk of colorectal cancer in Korean patients with gout. In this nested case-control study, we used data from 9920 CRC patients and 39,680 controls the Korean National Health Insurance Service-National Sample Cohort database. Propensity score overlap-weighted multivariate logistic regression analyses, adjusted for confounders, were used to assess the odds ratio (OR) and 95% confidence interval (CI) of the association between gout and CRC. Adjusted OR for CRC were similar between patients with gout and the control group (0.95; 95% CI, 0.86-1.04; p = 0.282). However, after adjustment, subgroup analysis revealed an 18% reduction in the probability of CRC among patients younger than 65 years with gout (95% CI, 0.70-0.95; p = 0.009). Conversely, absence of an association between gout and subsequent CRC persisted regardless of sex, income, residence, and Charlson Comorbidity Index score, even among individuals aged 65 years or older. These results imply that gout may not be a significant independent risk factor for CRC among the general population. However, in patients younger than 65 years with gout, a slightly reduced likelihood of CRC was observed. Further research is necessary to establish a causal relationship between gout and CRC and to generalize these findings to other populations.