Risk of intestinal and extra-intestinal cancers in patients with inflammatory bowel diseases: A population-based cohort study in northeastern Italy.
Adolescent
Adult
Aged
Aged, 80 and over
Colitis, Ulcerative
/ pathology
Colorectal Neoplasms
/ diagnosis
Crohn Disease
/ pathology
Disease Progression
Humans
Intestinal Neoplasms
/ diagnosis
Italy
Kaplan-Meier Estimate
Middle Aged
Population Surveillance
/ methods
Retrospective Studies
Risk Assessment
/ methods
Risk Factors
Young Adult
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
27
01
2020
accepted:
09
06
2020
entrez:
24
6
2020
pubmed:
24
6
2020
medline:
15
9
2020
Statut:
epublish
Résumé
The cancer risk of patients with inflammatory bowel diseases (IBD) has not been well documented in southern Europe. This study aimed to evaluate the overall pattern of cancer risk among patients with IBD in Friuli Venezia Giulia, northeastern Italy. A population-based cohort study was performed through a record linkage between local healthcare databases and the cancer registry (1995-2013). We identified 3664 IBD patients aged 18-84 years, including 2358 with ulcerative colitis (UC) and 1306 with Crohn's disease (CD). Sex- and age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were used to compare the cancer incidence of IBD patients with the general population. The cumulative cancer risk among IBD patients reached about 10% after 10 years of follow-up. A total of 246 cancers occurred among UC patients (SIR = 1.05, 95% CI: 0.92-1.19), and 141 among CD patients (SIR = 1.20, 95% CI: 1.01-1.41). As compared with the general population, no increased risk of colorectal cancers was observed for either UC or CD patients, whereas the risk of anal cancer was significantly elevated among UC patients (SIR = 6.03, 95% CI: 1.24-17.60). Increased risks were seen for specific extra-intestinal cancers, including corpus uteri (SIR = 2.67, 95% CI: 1.07-5.50) and kidney (SIR = 2.06, 95% CI: 1.03-3.69) among UC patients; thyroid (SIR = 5.58, 95% CI: 2.41-11.00) and skin non-melanoma (SIR = 1.86, 95% CI: 1.32-2.55) among CD patients. This population-based study showed that both UC and CD patients had a colorectal cancer risk similar to that of the general population. However, they were at a higher risk of developing certain extra-intestinal cancer types. Although detection biases cannot be excluded, the study findings pointed to a role of long-standing exposures to immunosuppressive therapies, underlying disease status, as well as the interactions with lifestyle factors. Our findings lent additional support to the need for monitoring the cancer burden in this at-risk population.
Identifiants
pubmed: 32574216
doi: 10.1371/journal.pone.0235142
pii: PONE-D-20-01444
pmc: PMC7310697
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0235142Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Crohns Colitis. 2019 Sep 27;13(10):1302-1310
pubmed: 30874294
Dis Colon Rectum. 2007 Jun;50(6):839-55
pubmed: 17308939
Gut. 2012 Sep;61(9):1279-83
pubmed: 22184069
Inflamm Bowel Dis. 2018 Feb 15;24(3):510-531
pubmed: 29462389
N Engl J Med. 2002 Aug 8;347(6):417-29
pubmed: 12167685
Gastroenterology. 2012 Aug;143(2):375-81.e1; quiz e13-4
pubmed: 22522090
Inflamm Bowel Dis. 2016 Dec;22(12):2902-2906
pubmed: 27846192
Am J Epidemiol. 2013 Jun 1;177(11):1296-305
pubmed: 23514635
Am J Gastroenterol. 2010 Jul;105(7):1480-7
pubmed: 20332773
Epidemiol Prev. 2008 May-Jun;32(3 Suppl):15-21
pubmed: 18928234
Dig Liver Dis. 2018 Jan;50(1):32-36
pubmed: 28988755
J Gastroenterol. 2016 Nov;51(11):1050-1062
pubmed: 27056729
J Crohns Colitis. 2017 May 1;11(5):571-577
pubmed: 28453756
Inflamm Bowel Dis. 2013 Mar-Apr;19(4):789-99
pubmed: 23448792
J Crohns Colitis. 2011 Oct;5(5):430-42
pubmed: 21939917
J Crohns Colitis. 2017 Aug 1;11(8):954-962
pubmed: 28333358
Mayo Clin Proc. 2015 Jun;90(6):738-46
pubmed: 25963756
Am J Gastroenterol. 2013 Dec;108(12):1869-76
pubmed: 23978954
Am J Gastroenterol. 2019 Jan;114(1):116-126
pubmed: 30333538
Gastroenterology. 2004 May;126(6):1504-17
pubmed: 15168363
Lancet. 2020 Jan 11;395(10218):123-131
pubmed: 31929014
Neurol Sci. 2018 Apr;39(4):699-704
pubmed: 29427166
Clin Gastroenterol Hepatol. 2009 Aug;7(8):874-81
pubmed: 19558997
Biomed Res Int. 2016;2016:5187061
pubmed: 27042663
BMC Nephrol. 2019 Mar 28;20(1):107
pubmed: 30922296
Clin Gastroenterol Hepatol. 2014 Feb;12(2):265-73.e1
pubmed: 23602821
Cancer Prev Res (Phila). 2016 Dec;9(12):887-894
pubmed: 27679553
Cancer Epidemiol. 2016 Apr;41:80-7
pubmed: 26851751
World J Surg Oncol. 2018 Sep 10;16(1):182
pubmed: 30200972
J Crohns Colitis. 2014 Jan;8(1):5-18
pubmed: 23664897
Gut. 2001 Apr;48(4):526-35
pubmed: 11247898
Cancer. 2001 Feb 15;91(4):854-62
pubmed: 11241255
J Crohns Colitis. 2014 Jan;8(1):19-30
pubmed: 23664498
Clin Colorectal Cancer. 2018 Mar;17(1):e29-e37
pubmed: 28712945
Inflamm Bowel Dis. 2007 Apr;13(4):451-61
pubmed: 17219403
Gastroenterology. 2011 May;140(6):1807-16
pubmed: 21530747
J Crohns Colitis. 2015 Nov;9(11):945-65
pubmed: 26294789
Int J Cancer. 2016 Sep 15;139(6):1270-80
pubmed: 27170593
Dig Liver Dis. 2014 Sep;46(9):777-82
pubmed: 24890621
Clin Epidemiol. 2018 Jun 07;10:671-681
pubmed: 29922093
Inflamm Bowel Dis. 2011 Jun;17(6):1423-7
pubmed: 21053358
Gastroenterology. 2010 May;138(5):1697-703
pubmed: 20167217
Gut. 2013 Nov;62(11):1523-8
pubmed: 23903238
J Crohns Colitis. 2015 Apr;9(4):326-33
pubmed: 25687203
Inflamm Bowel Dis. 2017 Nov;23(11):2061-2068
pubmed: 28991855
J Crohns Colitis. 2017 Aug 1;11(8):1011-1018
pubmed: 28379306
World J Gastroenterol. 2019 Feb 14;25(6):659-671
pubmed: 30783370
Gastroenterology. 2012 Aug;143(2):390-399.e1
pubmed: 22584081