Patients with pediatric-onset inflammatory bowel disease (IBD) may have an increased risk for developing cancer, particularly gastrointestinal cancers, according to a meta-analysis published online March 1 in JAMA Network Open.
Rahma Elmahdi, M.D., Ph.D., from the Center for Molecular Prediction of Inflammatory Bowel Disease at Aalborg University in Denmark, and colleagues conducted a systematic literature review and meta-analysis to evaluate the relative rate of cancer among patients with pediatric-onset IBD.
Based on five eligible population-based studies (19,812 individuals), the researchers identified 715 cases of cancer. Compared with the general population, there was a more than doubled increased rate of cancer among patients with pediatric-onset IBD (pooled relative rate [pRR], 2.46), including Crohn disease (pRR, 2.03) and ulcerative colitis (pRR, 2.61). This increase was driven by an increased rate of liver (pRR, 55.45), colorectal (pRR, 20.29), and small bowel (pRR, 16.20) cancers. Four studies revealed incidence rates ranging from 1.0 to 3.3 cases per 1,000 person-years among patients with pediatric-onset IBD.
"These results suggest that there is a greater than twofold increased rate of cancer among patients with pediatric-onset IBD compared with general pediatric populations, due primarily to an increased rate of gastrointestinal cancers," the authors write. "Identifying variables that modulate cancer risk in pediatric patients would be valuable for targeting prevention and screening."