Higher Risk for Hematological Malignancies in Inflammatory Bowel Disease: A Nationwide Population-based Study in Taiwan

Am J Gastroenterol. 2016 Sep;111(9):1313-9. doi: 10.1038/ajg.2016.239. Epub 2016 Jun 14.

Abstract

Objectives: The relationship between inflammatory bowel disease (IBD) and cancer remains unclear especially in Asian populations. Therefore, we conducted a nationwide population-based study in Taiwan to reveal the cancer risk in patients with IBD.

Methods: Using the national health database of Taiwan, we identified 3,348 IBD patients without previous cancer, including 685 with Crohn's disease (CD) and 2,663 with ulcerative colitis (UC), as a cohort from 1998 to 2012 and followed them up until 2013. Standardized incidence ratios (SIRs) of overall and site-specific cancers in CD and UC patients in comparison with the general population were analyzed.

Results: Regarding overall cancer risk analysis, both CD (SIR 1.4, 95% confidence interval (CI) 0.9-2.1) and UC (SIR 0.93, 95% CI 0.7-1.1) patients did not have a higher risk. In site-specific cancer risk analysis, CD (SIR 14.08, P<0.01) and UC (SIR 2.51, P=0.02) patients had a higher risk of hematological malignancies. The risk of colorectal cancer (CRC) did not increase significantly in either CD (SIR 0.96, P=0.7) or UC (SIR 1.39, P=0.22) patients.

Conclusions: This first nationwide population-based study in Asia reveals a significantly higher risk for hematological malignancies in IBD patients. This finding may highlight the importance of screening for hematological malignancies in patients with IBD in the future.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cohort Studies
  • Colitis, Ulcerative / epidemiology*
  • Crohn Disease / epidemiology*
  • Databases, Factual
  • Female
  • Hematologic Neoplasms / epidemiology*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Inflammatory Bowel Diseases / epidemiology
  • Leukemia / epidemiology
  • Lymphoma, Non-Hodgkin / epidemiology*
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Prevalence
  • Registries*
  • Retrospective Studies
  • Risk Factors
  • Taiwan / epidemiology
  • Young Adult