Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guo Xue Rd, Chengdu, 610041, Sichuan Province, China.
Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
J Cancer Res Clin Oncol. 2021 Apr;147(4):1077-1087. doi: 10.1007/s00432-020-03496-0. Epub 2021 Jan 12.
The purpose of this meta-analysis was to assess the associations between inflammatory bowel disease (IBD) and risk of the gastric, small bowel and colorectal cancer.
We searched the PubMed and Web of Science for observational studies published before June 2020, and the quality of each included study was evaluated according to the Newcastle-Ottawa-Scale.
Twenty-six studies comprising 531 449 IBD patients and more than 65 million reference individuals were included. Although IBD was significantly associated with 67% increased risk of the total gastric, small bowel and colorectal cancer. After stratifying by cancer location, IBD mainly increased the risk of intestinal cancer instead of gastric cancer. Furthermore, Crohn's disease (CD) significantly increased the risk of both small bowel cancer and colorectal cancer, while ulcerative colitis (UC) only increased the risk of colorectal cancer. In subgroup analysis, associations between IBD and risk of total gastric, small bowel and colorectal cancer were similar between male and female, except for that male IBD patients but not female had a significantly higher risk of small bowel cancer. Additionally, IBD patients in different geographical areas had different associations with risk of various gastrointestinal tract cancers.
IBD is mainly associated with increased risk of cancers in the lower gastrointestinal tract, including small bowel cancer and colorectal cancer. Because studies about the association between IBD and risk of gastric cancer and the populations in Asia are limited, more observational studies are required in the future.
本荟萃分析旨在评估炎症性肠病（IBD）与胃、小肠和结直肠癌风险之间的关联。
我们检索了 PubMed 和 Web of Science 中截至 2020 年 6 月发表的观察性研究，并根据 Newcastle-Ottawa 量表评估了每个纳入研究的质量。
纳入了 26 项研究，共包括 531449 例 IBD 患者和超过 6500 万例对照个体。尽管 IBD 与总胃癌、小肠癌和结直肠癌的风险增加 67%显著相关。但按癌症部位分层后，IBD 主要增加了肠癌风险，而不是胃癌风险。此外，克罗恩病（CD）显著增加了小肠癌和结直肠癌的风险，而溃疡性结肠炎（UC）仅增加了结直肠癌的风险。在亚组分析中，IBD 与总胃癌、小肠癌和结直肠癌风险之间的关联在男性和女性之间相似，除了男性 IBD 患者而不是女性患者患有小肠癌的风险显著增加。此外，不同地理区域的 IBD 患者与各种胃肠道癌症的风险之间存在不同的关联。
IBD 主要与下消化道癌症（包括小肠癌和结直肠癌）的风险增加相关。由于关于 IBD 与胃癌风险之间关联的研究以及亚洲人群的研究有限，未来需要更多的观察性研究。
