Intestinal and extra-intestinal cancer in Crohn's disease: follow-up of a population-based cohort in Copenhagen County, Denmark

TY - JOUR

T1 - Intestinal and extra-intestinal cancer in Crohn's disease

T2 - follow-up of a population-based cohort in Copenhagen County, Denmark

AU - Jess, T

AU - Winther, K V

AU - Munkholm, P

AU - Langholz, E

AU - Binder, V

PY - 2004/2/1

Y1 - 2004/2/1

N2 - AIM: To determine the long-term risk of intestinal and extra-intestinal malignancies in Crohn's disease patients in Copenhagen County, Denmark.METHODS: In Copenhagen County, a strictly population-based cohort of 374 patients with Crohn's disease diagnosed between 1962 and 1987 was followed until 1997 in order to determine the long-term risk of intestinal and extra-intestinal malignancies. Information on cancer occurrence was provided by the Danish National Cancer Registry and confirmed by the examination of hospital files. The observed number of cases was compared with the expected number, calculated from individually computed person-years at risk and 1995 cancer incidence rates for the background population.RESULTS: The risk of small bowel adenocarcinoma was significantly increased, independent of age and gender (standardized morbidity ratio, 66.7; 95% confidence interval, 18.1-170.7). The risk of colorectal cancer was not increased, either in the total group of patients or in patients with colonic Crohn's disease exclusively (standardized morbidity ratio, 1.64; 95% confidence interval, 0.20-5.92). Extra-intestinal cancer did not occur more frequently than expected.CONCLUSIONS: This population-based study of patients with Crohn's disease revealed no increase in colorectal cancer risk, possibly due to maintenance treatment with 5-aminosalicylic acid preparations and surgery in treatment failure. In contrast, the risk of small bowel cancer was increased more than 60-fold, but the numbers were small. The risk of extra-intestinal cancer was not increased and no lymphomas were observed.

AB - AIM: To determine the long-term risk of intestinal and extra-intestinal malignancies in Crohn's disease patients in Copenhagen County, Denmark.METHODS: In Copenhagen County, a strictly population-based cohort of 374 patients with Crohn's disease diagnosed between 1962 and 1987 was followed until 1997 in order to determine the long-term risk of intestinal and extra-intestinal malignancies. Information on cancer occurrence was provided by the Danish National Cancer Registry and confirmed by the examination of hospital files. The observed number of cases was compared with the expected number, calculated from individually computed person-years at risk and 1995 cancer incidence rates for the background population.RESULTS: The risk of small bowel adenocarcinoma was significantly increased, independent of age and gender (standardized morbidity ratio, 66.7; 95% confidence interval, 18.1-170.7). The risk of colorectal cancer was not increased, either in the total group of patients or in patients with colonic Crohn's disease exclusively (standardized morbidity ratio, 1.64; 95% confidence interval, 0.20-5.92). Extra-intestinal cancer did not occur more frequently than expected.CONCLUSIONS: This population-based study of patients with Crohn's disease revealed no increase in colorectal cancer risk, possibly due to maintenance treatment with 5-aminosalicylic acid preparations and surgery in treatment failure. In contrast, the risk of small bowel cancer was increased more than 60-fold, but the numbers were small. The risk of extra-intestinal cancer was not increased and no lymphomas were observed.

KW - Adenocarcinoma/drug therapy

KW - Adolescent

KW - Adult

KW - Aged

KW - Antimetabolites, Antineoplastic/therapeutic use

KW - Antineoplastic Agents, Hormonal/therapeutic use

KW - Azathioprine/therapeutic use

KW - Child

KW - Child, Preschool

KW - Cohort Studies

KW - Colorectal Neoplasms/drug therapy

KW - Crohn Disease/complications

KW - Denmark/epidemiology

KW - Female

KW - Follow-Up Studies

KW - Gastrointestinal Agents/therapeutic use

KW - Humans

KW - Ileal Neoplasms/drug therapy

KW - Infant

KW - Jejunal Neoplasms/drug therapy

KW - Male

KW - Middle Aged

KW - Prednisolone/therapeutic use

KW - Risk Factors

KW - Sulfasalazine/therapeutic use

KW - Treatment Outcome

M3 - Journal article

C2 - 14984375

SN - 0269-2813

VL - 19

SP - 287

EP - 293

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

IS - 3

ER -