Children with inflammatory bowel disease (IBD) face an increased risk of cancer that persists into adulthood, and is especially elevated for gastrointestinal cancers, according to a study published online in BMJ.
The international team, led by Ola Olen, MD, PhD, a pediatric gastroenterologist at the Karolinska Institute in Stockholm, compared 9405 patients in Sweden who were diagnosed with IBD before age 18 to a control group of 92,870 people without IBD.
The risk of cancer up to an average age of 30 was 3.3 cases per 1000 person-years among those with IBD. That compared with 1.5 cases per 1000 person-years in the control group. Cancer risk increased in the first year after IBD diagnosis and remained high beyond 5 years of follow-up, especially for gastrointestinal cancers such as in the colon, small intestine, and liver.
Chronic liver disease, longstanding colitis, and a family history of early cancer were risk factors for any cancer in individuals diagnosed with IBD as children.
“Our data show that patients with childhood-onset IBD have an increased risk of cancer, especially gastrointestinal cancers, lymphoid neoplasms, and skin cancer, both in childhood and later in life,” the authors write. “The relative risk of cancer does not seem to have diminished over time.”
Olén O, Askling J, Sachs MC, et al. Childhood onset inflammatory bowel disease and risk of cancer: a Swedish national cohort study 1964-2014. BMJ. 2017; 358:j3951.