Paediatric-onset IBD linked to cancer risk

Patients with paediatric-onset inflammatory bowel disease (IBD) suffer from a greater risk of developing malignancies, reports a new meta-analysis.

Sixty-six eligible studies were retrieved from the databases of Embase, PubMed/Medline, Scopus, Google Scholar, and the Cochrane Central Register of Controlled Trials. Overall, 38,092 patients were included. Only those that diagnosed IBD before the age of 18 years were eligible.

Six retrospective observational studies (n=17,450) reported cancer risk as standardized incidence ratio (SIR). Four studies found that patients with Crohn’s disease (CD) were more than twice as likely to develop cancer (pooled SIR, 2.42, 95 percent confidence interval [CI], 1.90–3.06; p<0.0001), and five studies showed similar estimates for ulcerative colitis (UC: pooled SIR, 2.10, 95 percent CI, 1.51–2.90; p<0.0001).

In the overall paediatric IBD sample, the pooled SIR of cancer was 2.39 (95 percent CI, 2.00–2.86; p<0.0001).

Subsequent analyses included nine prospective and 44 retrospective studies that reported incidence rates for all cancers in paediatric IBD patients. The pooled incidence rates in those with CD and UC were 0.014 (95 percent CI, 0.0087–0.021) and 0.031 (95 percent CI, 0.018–0.052), respectively. Site-specific malignancies, such as colorectal cancer and haematologic cancers, also occurred more frequently in paediatric IBD patients.

“[T]his systematic review and meta-analysis showed that patients with IBD diagnosed in childhood have an increased risk of cancers when compared with the general population. This risk appeared to be attributed mostly to the development of CRC and hematologic cancers,” researchers said.