Childhood-onset IBD is associated with an increased risk of cancer | ECCO
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Childhood-onset IBD is associated with an increased risk of cancer, both during childhood and later in life, especially gastrointestinal cancer.
Thiopurine treatment in children is unlikely to be a major risk factor for cancer development in IBD in this age group.
Why this matters
Inflammatory bowel disease (IBD) with onset in adult age has been linked to an increased risk of cancer, especially colorectal cancer, but risk assessments in childhood-onset IBD are scarce.
There were 509 (3.46/1000 person-years) first cancers in patients with childhood-onset IBD compared to 2237 (1.52/1000 person-years) in the general population comparators during follow-up, corresponding to a HR of 2.30.
HRs for any cancer were 3.19 in UC and 1.76 in CD.
While the relative risk was highest the first year of follow-up (HR=6.03), it remained elevated also after ≥5 years of follow-up (HR 2.29).
Patients with childhood-onset IBD also had an increased risk of cancer before their 18th birthday (HR 3.54); n=26 cancers in IBD).
Gastrointestinal cancers were associated with the highest relative risks (<18th birthday: HR 40; n=12 cancers in IBD); ≥18th birthday HR=18; n=194 cancers in IBD), but the absolute risks were low.