Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, China.
School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Am J Gastroenterol. 2022 May 1;117(5):785-793. doi: 10.14309/ajg.0000000000001674. Epub 2022 Feb 3.
To investigate the prospective association of irritable bowel syndrome (IBS) with long-term risk of overall, site-specific cancer and cancer-specific mortality in general population.
Participants free of inflammatory bowel disease, celiac disease, and any cancer at baseline from the UK Biobank were included, with patients with IBS as the exposure group and non-IBS patients as the reference group. The primary outcome was the incidence of overall cancer and cancer-specific mortality. Secondary outcomes included site-specific cancers and types of digestive cancers. The Cox proportional hazard model was used to investigate the associated risk of incident malignancies and related mortality.
Among 449,595 participants, 22,338 (5.0%) were diagnosed with IBS. During a median of 12.2-year follow-up, 2,937 cases of incident cancer were identified in patients with IBS (11.47 per 1,000 person-years), compared with 60,556 cases in reference individuals (12.51 per 1,000 person-years). Of these cases, 512 and 12,282 cancer-specific deaths occurred in IBS and non-IBS groups. Compared with non-IBS, the adjusted hazard ratio for overall cancer and cancer-specific mortality was 0.97 (95% confidence interval: 0.93-1.00, P = 0.062) and 0.83 (0.76-0.91, P < 0.001) among patients with IBS. Specifically, decreased risk of digestive (0.79 [0.71-0.89]), particularly colon (0.75 [0.62-0.90]) and rectal (0.68 [0.49-0.93]), cancers was observed in patients with IBS. Further sensitivity analysis and subgroup analysis by age and sex indicated similar results.
Compared with the general population, IBS does not increase the overall risk of cancer. Conversely, IBS is associated with lower risk of incident colorectal cancer and cancer-specific mortality.
本研究旨在探究肠易激综合征（IBS）与普通人群长期总体癌症及癌症特异性死亡率的相关性。
研究纳入了英国生物库中基线时无炎症性肠病、乳糜泻和任何癌症的参与者，将 IBS 患者作为暴露组，非 IBS 患者作为参照组。主要结局为总体癌症及癌症特异性死亡率的发生率。次要结局包括特定部位癌症和消化道癌症类型。采用 Cox 比例风险模型来探究恶性肿瘤发病的相关风险及其死亡率。
在 449595 名参与者中，22338 名（5.0%）被诊断为 IBS。在中位随访时间为 12.2 年期间，IBS 患者中有 2937 例（11.47/1000 人年）发生了新发癌症，而参照个体中有 60556 例（12.51/1000 人年）。在这些病例中，IBS 组和非 IBS 组分别有 512 例和 12282 例癌症特异性死亡。与非 IBS 相比，IBS 患者的总体癌症和癌症特异性死亡率的调整后风险比为 0.97（95%置信区间：0.93-1.00，P = 0.062）和 0.83（0.76-0.91，P < 0.001）。具体而言，IBS 患者的消化道癌（0.79 [0.71-0.89]），尤其是结肠癌（0.75 [0.62-0.90]）和直肠癌（0.68 [0.49-0.93]）的发病风险降低。
与普通人群相比，IBS 并不会增加癌症的总体风险。相反，IBS 与结直肠癌及癌症特异性死亡率的降低相关。
