Worldwide Incidence of Colorectal Cancer, Leukemia, and Lymphoma in Inflammatory Bowel Disease: An Updated Systematic Review and Meta-Analysis.
Background/Aims. Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer (CRC). In addition, there may be an association between leukemia and lymphoma and IBD. We conducted a systematic review and meta-analysis of the IBD literature to estimate the incidence of CRC, leukemia, and lymphoma in adult IBD patients. Methods. Studies were identified by a literature search of PubMed, Cochrane Library, Medline, Web of Science, Scopus, EMBASE, and ProQuest Dissertations and Theses. Pooled incidence rates (per 100,000 person-years [py]) were calculated through use of a random effects model, unless substantial heterogeneity prevented pooling of estimates. Several stratified analyses and metaregression were performed to explore potential study heterogeneity and bias. Results. Thirty-six articles fulfilled the inclusion criteria. For CRC, the pooled incidence rate in CD was 53.3/100,000 py (95% CI 46.3-60.3/100,000). The incidence of leukemia was 1.5/100,000 py (95% CI -0.06-3.0/100,000) in IBD, 0.3/100,000 py (95% CI -1.0-1.6/100,000) in CD, and 13.0/100,000 py (95% CI 5.8-20.3/100,000) in UC. For lymphoma, the pooled incidence rate in CD was 0.8/100,000 py (95% CI -0.4-2.1/100,000). Substantial heterogeneity prevented the pooling of other incidence estimates. Conclusion. The incidence of CRC, leukemia, and lymphoma in IBD is low.
School of Public Health, Department of Health Services, University of Washington, Seattle, WA 98195, USA; Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA 98195, USA.
Chelle L
CL
Wheat
Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA 98195, USA.
Kindra
K
Clark-Snustad
School of Public Health, Department of Health Services, University of Washington, Seattle, WA 98195, USA; School of Pharmacy, Department of Pharmacy, University of Washington, Seattle, WA 98195, USA.
Beth
B
Devine
School of Public Health, Department of Health Services, University of Washington, Seattle, WA 98195, USA.
David
D
Grembowski
School of Public Health, Department of Biostatistics, University of Washington, Seattle, WA 98195, USA.
Timothy A
TA
Thornton
Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA 98195, USA.
Cynthia W
CW
Ko