Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
The Ottawa Hospital, IBD Centre, Ottawa, Ontario, Canada.
Am J Gastroenterol. 2024 Nov 1;119(11):2275-2287. doi: 10.14309/ajg.0000000000002900. Epub 2024 Jun 25.
To study digestive system cancer risks in individuals with inflammatory bowel diseases (IBDs) in the biologic era.
We used population-level administrative and cancer registry data from Ontario, Canada, (1994-2020) to compare people with IBD to matched controls (1:10 by sex and birth year) on trends in age-sex standardized cancer incidence and risk ratios of incident cancers and cancer-related deaths.
Among 110,919 people with IBD and 1,109,190 controls, colorectal cancer incidence (per 100,000 person-years) declined similarly in people with ulcerative colitis (average annual percentage change [AAPC] -1.81; 95% confidence interval [CI] -2.48 to -1.156) and controls (AAPC -2.79; 95% CI -3.44 to -2.14), while small bowel cancer incidence rose faster in those with Crohn's disease (AAPC 9.68; 95% CI 2.51-17.3) than controls (AAPC 3.64; 95% CI 1.52-5.80). Extraintestinal digestive cancer incidence rose faster in people with IBD (AAPC 3.27; 95% CI 1.83-4.73) than controls (AAPC -1.87; 95% CI -2.33 to -1.42), particularly for liver (IBD AAPC 8.48; 95% CI 4.11-13.1) and bile duct (IBD AAPC 7.22; 95% CI 3.74-10.8) cancers. Beyond 2010, the incidences (and respective mortality rates) of colorectal (1.60; 95% CI 1.46-1.75), small bowel (4.10; 95% CI 3.37-4.99), bile duct (2.33; 95% CI 1.96-2.77), and pancreatic (1.19; 95% CI 1.00-1.40) cancers were higher in people with IBD.
Cancer incidence is declining for colorectal cancer and rising for other digestive cancers in people with IBD. Incidence and mortality remain higher in people with IBD than controls for colorectal, small bowel, bile duct, and pancreatic cancers.
研究生物时代炎症性肠病（IBD）患者消化系统癌症的风险。
我们使用来自加拿大安大略省的人群水平行政和癌症登记数据（1994-2020 年），比较 IBD 患者与匹配对照者（按性别和出生年份 1:10）的癌症发病率趋势以及癌症相关发病率和死亡率的比值比。
在 110919 名 IBD 患者和 1109190 名对照者中，溃疡性结肠炎患者的结直肠癌发病率（每 100000 人年）呈相似下降趋势（平均年百分比变化 [AAPC]-1.81；95%置信区间 [CI]-2.48 至-1.156），而对照组为（AAPC-2.79；95%CI-3.44 至-2.14），而克罗恩病患者的小肠癌发病率上升速度快于对照组（AAPC9.68；95%CI2.51-17.3）。IBD 患者的其他消化系统癌症发病率上升速度快于对照组（AAPC3.27；95%CI1.83-4.73），尤其是肝脏（IBD AAPC8.48；95%CI4.11-13.1）和胆管（IBD AAPC7.22；95%CI3.74-10.8）癌症。2010 年后，结直肠癌（1.60；95%CI1.46-1.75）、小肠癌（4.10；95%CI3.37-4.99）、胆管癌（2.33；95%CI1.96-2.77）和胰腺癌（1.19；95%CI1.00-1.40）的发病率（及相应死亡率）在 IBD 患者中更高。
IBD 患者的结直肠癌发病率下降，其他消化系统癌症发病率上升。IBD 患者的结直肠癌、小肠癌、胆管癌和胰腺癌的发病率和死亡率仍高于对照组。
