Intestinal and extra-intestinal cancer in Crohn's disease: follow-up of a population-based cohort in Copenhagen County, Denmark

被引:180
作者
Jess, T [1 ]
Winther, KV [1 ]
Munkholm, P [1 ]
Langholz, E [1 ]
Binder, V [1 ]
机构
[1] Univ Copenhagen, Herlev Hosp, Dept Med Gastroenterol, DK-1168 Copenhagen, Denmark
关键词
D O I
10.1111/j.1365-2036.2004.01858.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Aim: To determine the long-term risk of intestinal and extra-intestinal malignancies in Crohn's disease patients in Copenhagen County, Denmark. Methods: In Copenhagen County, a strictly population-based cohort of 3 74 patients with Crohn's disease diagnosed between 1962 and 1987 was followed until 1997 in order to determine the long-term risk of intestinal and extra-intestinal malignancies. Information on cancer occurrence was provided by the Danish National Cancer Registry and confirmed by the examination of hospital files. The observed number of cases was compared with the expected number, calculated from individually computed person-years at risk and 1995 cancer incidence rates for the background population. Results: The risk of small bowel adenocarcinoma was significantly increased, independent of age and gender (standardized morbidity ratio, 66.7; 95% confidence interval, 18.1-170.7). The risk of colorectal cancer was not increased, either in the total group of patients or in patients with colonic Crohn's disease exclusively (standardized morbidity ratio, 1.64; 95% confidence interval, 0.20-5.92). Extra-intestinal cancer did not occur more frequently than expected. Conclusions: This population-based study of patients with Crohn's disease revealed no increase in colorectal cancer risk, possibly due to maintenance treatment with 5-aminosalicylic acid preparations and surgery in treatment failure. In contrast, the risk of small bowel cancer was increased more than 60-fold, but the numbers were small. The risk of extra-intestinal cancer was not increased and no lymphomas were observed.
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页码:287 / 293
页数:7
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