Higher Risk for Hematological Malignancies in Inflammatory Bowel Disease: A Nationwide Population-based Study in Taiwan.
The relationship between inflammatory bowel disease (IBD) and cancer remains unclear especially in Asian populations. Therefore, we conducted a nationwide population-based study in Taiwan to reveal the cancer risk in patients with IBD.



Using the national health database of Taiwan, we identified 3,348 IBD patients without previous cancer, including 685 with Crohn's disease (CD) and 2,663 with ulcerative colitis (UC), as a cohort from 1998 to 2012 and followed them up until 2013. Standardized incidence ratios (SIRs) of overall and site-specific cancers in CD and UC patients in comparison with the general population were analyzed.



Regarding overall cancer risk analysis, both CD (SIR 1.4, 95% confidence interval (CI) 0.9-2.1) and UC (SIR 0.93, 95% CI 0.7-1.1) patients did not have a higher risk. In site-specific cancer risk analysis, CD (SIR 14.08, P<0.01) and UC (SIR 2.51, P=0.02) patients had a higher risk of hematological malignancies. The risk of colorectal cancer (CRC) did not increase significantly in either CD (SIR 0.96, P=0.7) or UC (SIR 1.39, P=0.22) patients.



This first nationwide population-based study in Asia reveals a significantly higher risk for hematological malignancies in IBD patients. This finding may highlight the importance of screening for hematological malignancies in patients with IBD in the future.
Division of Immunology, Department of Pediatrics, Kuo General Hospital, Tainan, Taiwan.
Li-Hui
LH
Wang
Division of Gastroenterology, Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
Yao-Jong
YJ
Yang
Division of Gastroenterology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Wei-Chun
WC
Cheng
Clinical Research Center, National Cheng Kung University Hospital, Tainan, Taiwan.
Wei-Ming
WM
Wang
Institute of Clinical Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan.
Sheng-Hsiang
SH
Lin
Institute of Clinical Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan.|Division of Immunology, Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
Chi-Chang
CC
Shieh
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000453:epidemiology*; D003424:Crohn Disease / Q000453:epidemiology*; D016208:Databases, Factual; D005260:Female; D019337:Hematologic Neoplasms / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology; D007938:Leukemia / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult