DOP44 Cancer risk in a high-incidence inflammatory bowel disease population: a Faroese IBD cohort study

Abstract Background The association between inflammatory bowel disease and malignancy is still controversial despite many observational studies. The Faroese population exhibits the highest occurrence of inflammatory bowel disease (IBD) in the world. The aim of this study was to investigate the risk of cancer in Faroese IBD patients within the nationwide Faroese IBD cohort. Methods This was a nationwide cohort study of all IBD patients diagnosed in the Faroe Islands from 1960 to 2014. Clinical demographics and cancer diagnosis were retrieved from patient files and from the Faroese cancer registry. Patients were followed until the event of cancer, death or emigration. Patients diagnosed with cancer prior to the IBD diagnosis were excluded. Observed numbers of cancer were compared with expected numbers based on ASR(N) (Nordic age- and sex-specific incidence rates) from Nordcan, by multiplying ASR(N) with person-years and follow-up in the study cohort and presented as standardised incidence ratios (SIRs) with 95 % intervals (CIs). Results The cohort consisted of 664 incidence IBD patients. After excluding 12 patients with cancer prior to IBD diagnosis, 652 patients with a total follow-up length of 11 476 person-years were included (414 UC with 7.494 patient-years, 128 IBDU with 2.038 patient-years and 110 CD with 1.944 patient-years). A total of 56 patients developed cancer during the follow-up period compared with 39.2 expected cases in the background population. We observed no gender difference. In UC, 33 observed compared with 25.7 expected patients developed cancer (SIR 1.28; 95% CI, 0.88–1.80). In IBDU, 13 observed compared with 6.9 expected patients developed cancer (SIR 1.88; 95% CI 1.00–0.22). In CD, 10 cases were observed compared with 6.6 expected (SIR 1.51; 95% CI 0.73–2.79). The most common types of cancers observed are shown in Table 1. Conclusion In this nationwide cohort study, we found no overall risk of cancer in IBD patients in the geographic isolated Faroe Island. However, skin cancer occurred more than expected in IBDU patients. This finding needs to be investigated further including the influence of treatment on cancer risk.

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P090 Risk of Rectal Cancer after Colectomy in Patients with Inflammatory Bowel Disease – A Nationwide Population-based Danish Cohort Study 1978–2018

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.219 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S189-S189

Author(s):

E Akimenko ◽

J T Bjerrum ◽

K H Allin ◽

A T Iversen ◽

T Jess

Keyword(s):

Inflammatory Bowel Disease ◽

Rectal Cancer ◽

Cohort Study ◽

Bowel Disease ◽

Subtotal Colectomy ◽

Population Based ◽

Source Population ◽

Background Population ◽

Inflammatory Bowel

Abstract Background The risk of surgery remains high both among patients with ulcerative colitis (UC) and patients with Crohn’s disease (CD) with a cumulative risk of subtotal colectomy with ileostomy and diverted rectum of 7.5% after 5 years in UC and a similar risk in CD. Ileostomy with diverted rectum after colectomy may be permanent, or the patient can undergo restorative surgery with ileo-rectal anastomosis (IRA) or ileal pouch-anal anastomosis (IPAA). Risk of rectal cancer in this patient population remains uncertain. We performed a nationwide population-based Danish study of rectal cancer (RC) risk after subtotal colectomy. Methods Through the Danish Civil Registration System, a source population of all individuals 15 years or older living in Denmark between 1978 and 2018 was retrieved. By use of the unique personal identification number given to all citizens at birth, this source population was linked to the Danish National Patient Registry (NPR) in order to identify all patients with inflammatory bowel disease (IBD). Patients with a diverted rectum, IRA or IPPA after colectomy were also identified with NPR. Cases of RC were identified in the Danish Cancer Registry. Patients with IBD were followed from the date of surgery until cancer, emigration, death or end of the study. The risk of RC in patients with diverted rectum was assessed using Cox regression analyses, as compared to the background population as well as to subjects with IBD without subtotal colectomy. Results RC occurred in 42 (0.9%) of 4931 patients after subtotal colectomy with diverted rectum, compared to 209 (0.4%) of 49,251 in the matched IBD cohort with no colectomy and 941 (0.4%) of 246,550 in the matched background population. In the IBD and subtotal colectomy population 11 (26%) of the 42 cases were in patients diagnosed with CD and 31 (74%) were in patients with UC. The hazard ratio (HR) for RC in IBD patients with diverted rectum vs. matched IBD patients without colectomy (adjusted for IBD type and sex) was 0.80 (95% CI 0.29, 2.17) during the first 10 years of follow-up and 7.93 (95% CI 5.48, 11.48) 10 years or more after colectomy. Likewise, the HR for RC in IBD patients with diverted rectum compared to the matched background population was 0.85 (95% CI 0.32, 2.28) during the first 10 years of follow-up and 10.25 (95% CI 7.36, 14.28) 10 years or more after colectomy. Conclusion In our nationwide population-based cohort study covering years 1978–2018 we observed an 8 to 10-fold increased risk of RC of the diverted rectum 10 years after colectomy.These data suggest a need for developing a specific surveillance strategy for this group of IBD patients.

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OP037 Risk of cancer in inflammatory bowel disease patients is associated with age and recent use of immunomodulators, while biologics and aminosalicylates are protective factors: a cross-sectional and follow-up analysis of the Swiss IBD cohort study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjx180.036 ◽

2018 ◽

Vol 12 (supplement_1) ◽

pp. S026-S027 ◽

Cited By ~ 1

Author(s):

T Greuther ◽

S Scharl ◽

C Barthel ◽

J -B Rossel ◽

L Biedermann ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Cohort Study ◽

Protective Factors ◽

Bowel Disease ◽

Cross Sectional ◽

Inflammatory Bowel ◽

Risk Of Cancer

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Cancer Risk in Inflammatory Bowel Disease According to Patient Phenotype and Treatment: A Danish Population-Based Cohort Study

The American Journal of Gastroenterology ◽

10.1038/ajg.2013.249 ◽

2013 ◽

Vol 108 (12) ◽

pp. 1869-1876 ◽

Cited By ~ 112

Author(s):

Tine Jess ◽

Erzsébet Horváth-Puhó ◽

Jan Fallingborg ◽

Henrik H Rasmussen ◽

Bent A Jacobsen

Keyword(s):

Inflammatory Bowel Disease ◽

Cohort Study ◽

Cancer Risk ◽

Bowel Disease ◽

Population Based ◽

Danish Population ◽

Inflammatory Bowel

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Inflammatory bowel disease and new-onset psychiatric disorders in pregnancy and post partum: a population-based cohort study

Gut ◽

10.1136/gutjnl-2018-317610 ◽

2019 ◽

Vol 68 (9) ◽

pp. 1597-1605 ◽

Cited By ~ 5

Author(s):

Simone N Vigod ◽

Paul Kurdyak ◽

Hilary K Brown ◽

Geoffrey C Nguyen ◽

Laura E Targownik ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Mental Illness ◽

Cohort Study ◽

Bowel Disease ◽

Post Partum ◽

Population Based ◽

Incidence Rates ◽

Increased Risk ◽

Inflammatory Bowel ◽

New Onset

ObjectivePatients with inflammatory bowel disease (IBD) have an elevated risk of mental illness. We determined the incidence and correlates of new-onset mental illness associated with IBD during pregnancy and post partum.DesignThis cohort study using population-based health administrative data included all women with a singleton live birth in Ontario, Canada (2002–2014). The incidence of new-onset mental illness from conception to 1-year post partum was compared between 3721 women with and 798 908 without IBD, generating adjusted HRs (aHR). Logistic regression was used to identify correlates of new-onset mental illness in the IBD group.ResultsAbout 22.7% of women with IBD had new-onset mental illness versus 20.4% without, corresponding to incidence rates of 150.2 and 132.8 per 1000 patient-years (aHR 1.12, 95% CI 1.05 to 1.20), or one extra case of new-onset mental illness per 43 pregnant women with IBD. The risk was elevated in the post partum (aHR 1.20, 95% CI 1.09 to 1.31), but not during pregnancy, and for Crohn’s disease (aHR 1.12, 95% CI 1.02 to 1.23), but not ulcerative colitis. The risk was specifically elevated for a new-onset mood or anxiety disorder (aHR 1.14, 95% CI 1.04 to 1.26) and alcohol or substance use disorders (aHR 2.73, 95% CI 1.42 to 5.26). Predictors of a mental illness diagnosis were maternal age, delivery year, medical comorbidity, number of prenatal visits, family physician obstetrical care and infant mortality.ConclusionWomen with IBD were at an increased risk of new-onset psychiatric diagnosis in the postpartum period, but not during pregnancy. Providers should look to increase opportunities for prevention, early identification and treatment accordingly.

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