Children with inflammatory bowel disease (IBD) face a higher risk of cancer later in life, a Swedish study has concluded.
The study, “Childhood onset inflammatory bowel disease and risk of cancer: a Swedish nationwide cohort study 1964-2014,” appeared in the journal BMJ. It found that such children have a higher incidence of gastrointestinal cancers, lymphoid neoplasms and skin cancer, both during childhood and adulthood.
Scientists already know that adults with ulcerative colitis and Crohn’s disease are more at risk of developing colorectal cancer. Other factors such as family history of colorectal cancer and concomitant primary sclerosing cholangitis — a chronic liver disease — are also associated with cancer in patients with adult-onset IBD.
Yet little evidence supports a link between childhood-onset IBD and cancer risk.
A research team led by pediatric gastroenterologist Ola Olén of Sachs’ Children and Youth Hospital in Stockholm, analyzed clinical data gathered from the Swedish National Patient Register from 1964 to 2014. The list included 9,405 patients with childhood onset IBD.
Following these patients until the age of 27, researchers found that those with childhood IBD were 2.2 times more likely to develop cancer than people of similar age and gender who did not have bowel diseases. Patients with diagnosed ulcerative colitis during childhood were 2.6 times more likely, and those with Crohn’s disease had 1.7 times more likely to get cancer later in life, researchers found.
Colorectal, small intestinal and liver cancer were among the most common cancers in this population. Patients with childhood-onset IBD were 18 times more likely to develop gastrointestinal cancers than the general population. In addition, these patients also showed increased incidence of lymphoid neoplasms, melanoma and non-melanoma skin cancers.
Analysis of cancer incidence among various age groups showed no statistical difference, not even when analyzed according to calendar years or periods. This observation suggests that the cancer incidence and cancer-associated risk in this childhood-onset IBD population has not changed in the last 50 years.
“We found an increased risk of cancer in childhood-onset inflammatory bowel disease in childhood and later in life, especially gastrointestinal cancer and lymphoid neoplasms,” the researchers wrote. Yet despite the introduction of more advanced therapies in IBD patient treatment regimens, such as thiopurines or biological therapies, cancer incidence has not changed in this population.
“Future surveillance programs need to take these findings into account,” they concluded.