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. 

Key results

  • 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.
  • Pat...