Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
J Crohns Colitis. 2017 Aug 1;11(8):954-962. doi: 10.1093/ecco-jcc/jjx040.
The association between inflammatory bowel disease [IBD] and cancer remains poorly defined in Asian populations. Therefore, we conducted a nationwide population-based study to determine the cancer risk in Korean patients with IBD.
Using the National Health Insurance claims data, we collected data on patients diagnosed with IBD (5595 Crohn's disease [CD] and 10 049 ulcerative colitis [UC]) from 2011 to 2014. Standardized incidence ratios [SIRs] of overall and site-specific cancers in IBD patients in comparison with the general population were calculated.
The overall cancer risk was higher in CD patients [SIR, 2.2; 95% confidence interval, 1.5-3.0 in men and 3.3; 2.4-4.5 in women] and UC patients [1.9; 1.6-2.3 in men and 1.9; 1.5-2.4 in women]. There were significantly increased risks for the following cancers: small bowel cancer [31.2; 3.8-112.8], colorectal cancer [CRC] [3.7; 1.6-7.2] and haematological cancer [4.0; 1.1-10.3] in men with CD; small bowel cancer [61.1; 7.4-220.6], CRC [4.7; 1.5-10.9], liver cancer [15.3; 5.6-33.2], pancreatic cancer [8.6; 1.0-31.0] and haematological cancer [11.0; 3.6-25.7] in women with CD; CRC [2.1; 1.3-3.3] and cancer of the prostate [3.5; 2.1-5.5], brain/central nervous system [6.1; 1.3-17.9] and thyroid [2.2; 1.1-3.9] in men with UC; and CRC [3.0; 1.5-5.3], cancer of the liver [4.4; 1.6-9.7] and cervix uteri [5.7; 2.4-11.1], and haematological cancer [3.5; 1.1-8.1] in women with UC. Women with CD had an increased risk of non-Hodgkin lymphoma [NHL] and leukaemia. Women with UC had an increased risk of NHL.
Korean patients with IBD are at increased risk for overall, intestinal and haematological cancer.
炎症性肠病(IBD)与癌症之间的关联在亚洲人群中仍未得到明确界定。因此,我们进行了一项全国性的基于人群的研究,以确定韩国 IBD 患者的癌症风险。
使用国家健康保险索赔数据,我们收集了 2011 年至 2014 年间诊断为 IBD(5595 例克罗恩病 [CD] 和 10049 例溃疡性结肠炎 [UC])的患者数据。计算 IBD 患者的总体和特定部位癌症的标准化发病比(SIR),并与一般人群进行比较。
CD 患者的总体癌症风险较高[SIR,2.2;95%置信区间,男性为 1.5-3.0,女性为 3.3;2.4-4.5]和 UC 患者[SIR,1.9;1.6-2.3男性和 1.9;1.5-2.4女性]。男性 CD 患者的以下癌症风险显著增加:小肠癌[31.2;3.8-112.8]、结直肠癌[CRC] [3.7;1.6-7.2]和血液癌[4.0;1.1-10.3];女性 CD 患者的小肠癌[61.1;7.4-220.6]、CRC [4.7;1.5-10.9]、肝癌[15.3;5.6-33.2]、胰腺癌[8.6;1.0-31.0]和血液癌[11.0;3.6-25.7];男性 UC 患者的 CRC [2.1;1.3-3.3]和前列腺癌[3.5;2.1-5.5]、脑/中枢神经系统[6.1;1.3-17.9]和甲状腺[2.2;1.1-3.9];女性 UC 患者的 CRC [3.0;1.5-5.3]、肝癌[4.4;1.6-9.7]和子宫颈[5.7;2.4-11.1]和血液癌[3.5;1.1-8.1]。CD 女性患者患非霍奇金淋巴瘤(NHL)和白血病的风险增加。UC 女性患者患 NHL 的风险增加。
韩国 IBD 患者患总体癌症、肠道癌和血液癌的风险增加。