title: Total and cancer mortality in a cohort of ulcerative colitis and Crohn's disease patients: The Florence inflammatory bowel disease study, 1978-2010.
abstract: BACKGROUND
  There is no consensus on the leading causes of death among inflammatory bowel diseases (IBD) patients.
  
  
  OBJECTIVE
  We present the results of an extended follow-up of the population-based Florence IBD cohort, including 689 ulcerative colitis and 231 Crohn's disease patients.
  
  
  METHODS
  The causes of death of cohort members were determined through linkage with the local mortality registry. We calculated standardized mortality ratios (SMR) and 95% confidence intervals (95%CI) by applying gender-, age- and calendar time-death rates to person-years at risk.
  
  
  RESULTS
  Ulcerative colitis patients had overall mortality comparable to the general population (SMR 0.99, 95%CI 0.85-1.14), though being at increased risk of dying from Hodgkin's disease (SMR 11.74, 95%CI 2.94-46.94), rectal cancer (SMR 3.69, 95%CI 1.66-8.22) and Alzheimer's disease (2.40, 95%CI 1.00-5.76). Crohn's disease patients had an increased overall mortality (SMR 1.79, 95%CI 1.39-2.27) and were at higher risk of dying from cancer (SMR 2.57, 95%CI 1.28-5.13) and non-cancer diseases of the respiratory system (SMR 2.51, 95%CI 1.05-6.04), brain cancer (SMR 6.26, 95%CI 1.57-25.02) and non-cancer diseases of the genitourinary system (SMR 4.38, 95%CI 1.10-17.52).
  
  
  CONCLUSIONS
  IBD patients should be offered counselling on risk reduction strategies, as much of their mortality excess is potentially avoidable.
authors.affiliation: Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
authors.forename: Saverio
authors.initials: S
authors.lastname: Caini
authors.affiliation: Emergency Department, Gastroenterology, SOD2, AOU Careggi, Florence, Italy.
authors.forename: Siro
authors.initials: S
authors.lastname: Bagnoli
authors.affiliation: Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy. Electronic address: d.palli@ispo.toscana.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.affiliation: Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
authors.forename: Calogero
authors.initials: C
authors.lastname: Saieva
authors.affiliation: Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ceroti
authors.affiliation: Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Bendinelli
authors.affiliation: Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
authors.forename: Melania
authors.initials: M
authors.lastname: Assedi
authors.affiliation: Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Masala
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000401:mortality; D001932:Brain Neoplasms / Q000401:mortality; D002423:Cause of Death; D003093:Colitis, Ulcerative / Q000401:mortality*; D003424:Crohn Disease / Q000401:mortality*; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000401:mortality; D012042:Registries; D012140:Respiratory Tract Diseases / Q000401:mortality
keywords: Cancer mortality; Crohn's disease; Inflammatory bowel diseases; Ulcerative colitis