Extracolonic malignancies in inflammatory bowel disease.
A population-based cohort with inflammatory bowel disease consisting of 4776 patients (3121 with ulcerative colitis and 1655 with Crohn's disease) was followed for 1 to 50 years for the occurrence of malignant neoplasms. Two hundred eighty-three cancers were observed versus 189.1 expected (standardized incidence ratio [SIR] = 1.5, 95% confidence limits [CL] 1.3 to 1.7). One hundred seventy-eight extracolonic cancers were observed versus 168.8 expected (SIR = 1.1, 95% CL 0.9 to 1.2). In Crohn's disease and extensive ulcerative colitis, observed cases were close to those expected but in ulcerative proctitis, the relative risk of extracolonic cancers was close to significantly increased (SIR = 1.3, 95% CL 1.0 to 1.7). Squamous skin cancers after Crohn's disease (SIR = 5.5, 95% CL 2.0 to 11.9) and connective tissue cancers after ulcerative colitis (SIR = 4.0, 95% CL 1.0 to 10.2) were significantly increased. Those having extensive ulcerative colitis at diagnosis had an increased risk of brain cancers (SIR = 2.4, 95% CL 1.0 to 4.6). Patients with extensive ulcerative colitis had lower than expected risk of breast cancer (SIR = 0.4, 95% CL 0.1 to 1.0).
Ekbom
A
A
Department of Surgery, University Hospital, Uppsala, Sweden.
Helmick
C
C
Zack
M
M
Adami
H O
HO
D001932:Brain Neoplasms / Q000453:epidemiology; D001943:Breast Neoplasms / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications*; D003424:Crohn Disease / Q000150:complications*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology