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Risk Factors of Cancer in Pediatric-Onset Inflammatory Bowel Disease in Denmark and Finland

Mikkel Malham1,2,3, Sabine Jansson1,2, Petter Malmborg4,5

  • 1From the Department of Paediatric and Adolescence Medicine, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark.

Journal of Pediatric Gastroenterology and Nutrition
|March 24, 2023
PubMed

Insights

Pediatric inflammatory bowel disease (pIBD) patients treated with thiopurines face a higher risk of treatment-associated cancer (TAC). Lower IBD relapse frequency was linked to increased disease-associated cancer (DAC) risk in this pIBD study.

Area of Science:

  • Gastroenterology
  • Pediatric Oncology
  • Clinical Epidemiology

Background:

  • Pediatric-onset inflammatory bowel disease (pIBD) is associated with an elevated risk of various cancers.
  • Understanding the interplay between pIBD, its treatment, and cancer development is crucial for patient management.

Purpose of the Study:

  • To investigate the impact of medical treatments and disease activity on the risk of developing disease-associated cancer (DAC) and treatment-associated cancer (TAC) in patients with pIBD.
  • To quantify the risk of DAC and TAC in relation to specific therapies and disease course.

Main Methods:

  • A case-control study utilizing data from a nationwide cohort of pIBD patients in Denmark and Finland (1992-2015).
  • Manual review of patient charts to collect data on phenotype, medical treatment, surgery, and relapses.
  • Logistic regression analysis was employed to calculate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for assessing relative risks.

Main Results:

  • A reduced frequency of IBD relapses was associated with an increased risk of DAC (OR 0.2).
  • Patients receiving thiopurines demonstrated a significantly increased risk of TAC (aOR 11.7).
  • The proportion of follow-up time exposed to thiopurines was also associated with an increased risk of TAC (aOR 5.6).

Conclusions:

  • Thiopurine treatment in pediatric-onset inflammatory bowel disease (pIBD) patients is linked to a higher risk of treatment-associated cancer (TAC).
  • This study highlights the importance of monitoring cancer risk in pIBD patients, particularly those undergoing specific medical treatments.
Abstract

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