Mellemkjaer L, Johansen C, Gridley G, Linet M S, Kjaer S K, Olsen J H
Danish Cancer Society, Institute of Cancer Epidemiology, Copenhagen O.
Cancer Causes Control. 2000 Feb;11(2):145-50. doi: 10.1023/a:1008988215904.
The large number of studies of intestinal cancer among patients with Crohn's disease have provided inconsistent risk estimates in regard to risk of both colorectal and small intestinal cancer. We investigated incidence of cancer among Crohn's disease patients in comparison with the incidence in the general population of Denmark.
From the Danish National Registry of Patients we identified 2645 patients who had been hospitalized with Crohn's disease during 1977-1989. Cancer incidence for up to 17 years was determined in the cohort and compared to an expected number derived from national cancer incidence rates.
The 15 observed cases of colorectal cancer were close to the expected number of 13.1 (SIR = 1.1; 95% CI 0.6-1.9), whereas the five cases of small intestinal cancer (three adenocarcinomas and two carcinoids) observed corresponded to an 18-fold increased risk (SIR = 17.9; 95% CI 5.8-42).
A potential excess of colorectal cancer among subgroups of patients with Crohn's disease was not detectable in the overall risk estimate for colorectal cancer. Only for small intestinal cancer was a significantly elevated risk found among these patients hospitalized with Crohn's disease.
大量关于克罗恩病患者患肠癌的研究，在结直肠癌和小肠癌风险方面给出了不一致的风险估计。我们调查了克罗恩病患者的癌症发病率，并与丹麦普通人群的发病率进行比较。
我们从丹麦国家患者登记处识别出1977年至1989年间因克罗恩病住院的2645名患者。确定该队列长达17年的癌症发病率，并与根据国家癌症发病率得出的预期病例数进行比较。
观察到的15例结直肠癌病例接近预期的13.1例（标准化发病比[SIR]=1.1；95%置信区间0.6-1.9），而观察到的5例小肠癌病例（3例腺癌和2例类癌）对应的风险增加了18倍（SIR=17.9；95%置信区间5.8-42）。
在结直肠癌的总体风险估计中，未发现克罗恩病患者亚组中潜在的结直肠癌超额风险。仅在这些因克罗恩病住院的患者中发现小肠癌风险显著升高。
