A Population-Based Matched Cohort Study of Digestive System Cancer Incidence and Mortality in Individuals With and Without Inflammatory Bowel Disease

被引：5

作者：

Murthy, Sanjay K. ^{[1
,2
,3
,4
,5
]}

Tandon, Parul ^{[5
,6
]}

Matthews, Priscilla ^{[7
]}

Ahmed, Faria ^{[4
]}

Pugliese, Michael ^{[5
]}

Taljaard, Monica ^{[4
,5
]}

Kaplan, Gilaad G. ^{[8
]}

Coward, Stephanie ^{[8
]}

Bernstein, Charles ^{[9
,10
,11
]}

Benchimol, Eric I. ^{[5
,12
,13
,14
,15
]}

Kuenzig, M. Ellen ^{[12
,13
]}

Targownik, Laura E. ^{[16
,17
]}

Singh, Harminder ^{[9
,10
,11
,18
]}

机构：

[1] Univ Ottawa, Dept Med, Ottawa, ON, Canada

[2] Univ Ottawa, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada

[3] Ottawa Hosp, IBD Ctr, Ottawa, ON, Canada

[4] Ottawa Hosp, Res Inst, Ottawa, ON, Canada

[5] ICES, Toronto, ON, Canada

[6] Univ Toronto, Univ Hlth Network, Div Gastroenterol & Hepatol, Toronto, ON, Canada

[7] Queens Univ, Dept Med, Kingston, ON, Canada

[8] Univ Calgary, Cumming Sch Med, Dept Community Hlth Sci, Div Gastroenterol & Hepatol,Dept Med, Calgary, AB, Canada

[9] Univ Manitoba, IBD Clin & Res Ctr, Winnipeg, MB, Canada

[10] Univ Manitoba, Max Rady Coll Med, Rady Fac Hlth Sci, Dept Internal Med, Winnipeg, MB, Canada

[11] Univ Manitoba, Max Rady Coll Med, Rady Fac Hlth Sci, Dept Community Hlth Sci, Winnipeg, MB, Canada

[12] Hosp Sick Children, SickKids Inflammatory Bowel Dis Ctr, Div Gastroenterol Hepatol & Nutr, Toronto, ON, Canada

[13] Hosp Sick Children, SickKids Res Inst, Child Hlth Evaluat Sci, Toronto, ON, Canada

[14] Univ Toronto, Dept Paediat, Toronto, ON, Canada

[15] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada

[16] Mt Sinai Hosp, Gastroenterol IBD, Toronto, ON, Canada

[17] Univ Toronto, Div Gastroenterol & Hepatol, Toronto, ON, Canada

[18] Paul Albrechtsen Res Inst CancerCare Manitoba, Winnipeg, MB, Canada

来源：

AMERICAN JOURNAL OF GASTROENTEROLOGY | 2024年 / 119卷 / 11期

基金：

加拿大健康研究院;

关键词：

inflammatory bowel disease; Crohn's disease; ulcerative colitis; cancer; epidemiology; incidence; mortality; trends; relative risk; rate ratio; EARLY COMBINED IMMUNOSUPPRESSION; NECROSIS-FACTOR ANTAGONISTS; CROHNS-DISEASE; ULCERATIVE-COLITIS; COLORECTAL-CANCER; EXTRAINTESTINAL CANCER; RISK; METAANALYSIS; MANAGEMENT; VALIDATION;

D O I：

10.14309/ajg.0000000000002900

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

INTRODUCTION:To study digestive system cancer risks in individuals with inflammatory bowel diseases (IBDs) in the biologic era. METHODS:We used population-level administrative and cancer registry data from Ontario, Canada, (1994-2020) to compare people with IBD to matched controls (1:10 by sex and birth year) on trends in age-sex standardized cancer incidence and risk ratios of incident cancers and cancer-related deaths. RESULTS:Among 110,919 people with IBD and 1,109,190 controls, colorectal cancer incidence (per 100,000 person-years) declined similarly in people with ulcerative colitis (average annual percentage change [AAPC] -1.81; 95% confidence interval [CI] -2.48 to -1.156) and controls (AAPC -2.79; 95% CI -3.44 to -2.14), while small bowel cancer incidence rose faster in those with Crohn's disease (AAPC 9.68; 95% CI 2.51-17.3) than controls (AAPC 3.64; 95% CI 1.52-5.80). Extraintestinal digestive cancer incidence rose faster in people with IBD (AAPC 3.27; 95% CI 1.83-4.73) than controls (AAPC -1.87; 95% CI -2.33 to -1.42), particularly for liver (IBD AAPC 8.48; 95% CI 4.11-13.1) and bile duct (IBD AAPC 7.22; 95% CI 3.74-10.8) cancers. Beyond 2010, the incidences (and respective mortality rates) of colorectal (1.60; 95% CI 1.46-1.75), small bowel (4.10; 95% CI 3.37-4.99), bile duct (2.33; 95% CI 1.96-2.77), and pancreatic (1.19; 95% CI 1.00-1.40) cancers were higher in people with IBD. DISCUSSION:Cancer incidence is declining for colorectal cancer and rising for other digestive cancers in people with IBD. Incidence and mortality remain higher in people with IBD than controls for colorectal, small bowel, bile duct, and pancreatic cancers.

引用

页码：2275 / 2287

页数：13

共 64 条

[31] Risk of Lymphoma in Patients With Inflammatory Bowel Disease Treated With Azathioprine and 6-Mercaptopurine: A Meta-analysis [J].