Department of Medicine, VA North Texas Healthcare System, Dallas, Texas.
Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Inflamm Bowel Dis. 2018 Feb 15;24(3):617-623. doi: 10.1093/ibd/izx046.
The risk for colorectal cancer (CRC) and certain extracolonic cancers is thought to be increased in inflammatory bowel disease (IBD), but few recent US studies have evaluated this issue. We aimed to estimate the incidence of CRC and extracolonic cancers in IBD patients.
In this case-control study, cases were all IBD patients treated in our Department of Veterans Affairs (VA) hospital who developed CRC or extracolonic cancers between 1996 and 2015. Controls were patients in the general VA population who developed these cancers during the same time. We compared cancer incidence rates (IRs) in cases and controls.
There was no significant difference between cases and controls in the 20-year IR for CRC (148/100 000 in IBD patients, 97/100 000 in controls; relative risk [RR], 1.53; 95% confidence interval [CI], 0.86-2.69). In contrast, IBD cases had a significantly higher 20-year IR for all extracolonic cancers than controls (2839/100 000 in IBD patients, 1960/100 000 in controls; RR, 1.45; 95% CI, 1.27-1.65). Site-specific analyses revealed that IBD patients had significantly elevated risks for nonmelanoma skin cancers (RR, 2.38; 95% CI, 1.99-2.85), melanoma skin cancers (RR, 2.85; 95% CI, 1.63-4.88), renal tumors (RR, 2.90; 95% CI, 1.46-5.84), prostate cancer (RR, 1.70; 95% CI, 1.28-2.27), and pancreatic cancer (RR, 4.23; 95% CI, 1.35-13.29).
The incidence of CRC was not significantly higher in our veteran patients with IBD than in control patients in the general VA population. In contrast, our IBD patients had a significantly higher risk for extracolonic cancers than controls, including cancers of the skin, kidneys, prostate, and pancreas. 10.1093/ibd/izx046_video1Video 1.izx046_Mosher_Video5734484616001.
据认为，炎症性肠病（IBD）患者的结直肠癌（CRC）和某些结外癌症的风险增加，但最近很少有美国研究评估这一问题。我们旨在估计 IBD 患者中 CRC 和结外癌症的发病率。
在这项病例对照研究中，病例均为在我们退伍军人事务部（VA）医院接受治疗的 IBD 患者，他们在 1996 年至 2015 年间患有 CRC 或结外癌症。对照组为在同一时期患有这些癌症的 VA 普通人群中的患者。我们比较了病例和对照组的癌症发病率（IR）。
在 20 年 CRC 的 IR 方面，病例与对照组之间没有显著差异（IBD 患者为 148/100000，对照组为 97/100000；相对风险 [RR]，1.53；95%置信区间 [CI]，0.86-2.69）。相比之下，IBD 病例的所有结外癌症 20 年 IR 明显高于对照组（IBD 患者为 2839/100000，对照组为 1960/100000；RR，1.45；95%CI，1.27-1.65）。针对特定部位的分析显示，IBD 患者患非黑色素瘤皮肤癌（RR，2.38；95%CI，1.99-2.85）、黑色素瘤皮肤癌（RR，2.85；95%CI，1.63-4.88）、肾肿瘤（RR，2.90；95%CI，1.46-5.84）、前列腺癌（RR，1.70；95%CI，1.28-2.27）和胰腺癌（RR，4.23；95%CI，1.35-13.29）的风险显著增加。
我们的退伍军人 IBD 患者的 CRC 发病率与 VA 普通人群中的对照组患者相比没有显著升高。相比之下，我们的 IBD 患者发生结外癌症的风险明显高于对照组，包括皮肤、肾脏、前列腺和胰腺的癌症。
