October 20, 2021
2 minutes reading
Source/Disclosures Published by:
Source:
Dupont-Lucas C, et al. Summary OP098. Presented at: UEG Week; October 3-5, 2021 (virtual meeting).
disclosures:
Dupont-Lucas reports that he has worked as a clinical consultant for AbbVie.
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According to a presentation at UEG Week Virtual 2021, patients with childhood inflammatory bowel disease have a higher risk of cancer and death.
“As you know, the incidence of IBD in children has increased dramatically in recent decades,” Claire Dupont-Lucas, MD, doctorate, MPH, of the department of pediatrics at the University Hospital of Caen in France, said. “IBD in children is characterized by a more severe course in adults with IBD. Although cancer and death are feared complications of IBD, they are rarely observed during pediatric disease follow-up. Therefore, the risk of cancer and mortality in childhood IBD is poorly known.”
To investigate the prevalence of cancer and mortality in patients with childhood IBD and to identify the factors associated with cancer and mortality, researchers used the EPIMAD registry to review data from pediatric patients diagnosed with IBD before the age of 17 years from 1988 to 2011. Incident cancer data were collected through December 31, 2013. The final cohort consisted of 1,344 patients with either Crohn’s disease (75%; median age, 14.5 years; 55.2% boys) or ulcerative colitis (25%; median age, 13.9 years; 42.7). % boys). Data from the French population served as a reference group.
The median duration of follow-up was 13.1 years. Researchers recorded 14 cases of cancer (median delay after IBD diagnosis, 15 years; median age at cancer diagnosis, 27.8 years) in the cohort; 11 cases occurred in patients with CD and three in patients with UC. There was a significantly higher incidence of cancer compared to the general population (standardized cancer incidence ratio [SIR] = 2.66; 95% CI, 1.47-4.8). Colorectal cancer (SIR = 41.2; 95% CI, 17.55-98.98), followed by skin cancer (basal cell carcinoma and melanoma), were the leading causes of death, according to Dupont-Lucas.
“Looking at colorectal cancer, the risk was increased 41-fold compared to the general population and 76-fold for UC patients. The risk of melanoma was also fivefold compared to the general population,” Dupont-Lucas said.
Researchers recorded 15 deaths (median delay after IBD diagnosis, 15.9 years; median age at death, 28.8 years), including 14 in patients with CD and all in patients diagnosed with IBD before 2004. The overall death rate was higher than the reference population (standardized mortality rate [SMR] = 1.69; 95% CI, 1.02-2.8). Four deaths were attributed to cancer.
Although the risk of death from CRC was 70-fold greater compared to the general population (SMR = 70.37; 95% CI, 22.7-218.19), Dupont-Lucas found no association between duration of treatment with immunosuppressants or antitumor necrosis factor therapy and cancer prevention.
“The mortality and risk of cancer in young adults with childhood IBD is 2.7 times higher for cancer and 1.7 times for death,” concluded Dupont-Lucas. “The leading cause of cancer death is colorectal cancer, we recommend implementing cancer programs from adolescence. While we did not find an association between treatment exposure and cancer or death, longer follow-up of the most recently diagnosed group will be needed.” to confirm these results.”
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