Increased Risk of Cancer Among Patients With Pediatric-Onset IBD

In a recent analysis, researchers found an increased rate of cancer among patients with pediatric-onset inflammatory bowel disease (IBD) compared to the general population, primarily due to increased rate of gastrointestinal cancers among these patients.

While the risk of cancer among adult patients with IBD is well investigated, little information exists regarding the risk among those with pediatric-onset IBD. Pediatric patients with IBD may have longer exposure to the chronic inflammatory state that can lead to complications such as cancer. Due to the increasing incidence of pediatric-onset IBD, it is important for clinicians to be aware of long-term risks of cancer within this patient population.

Researchers conducted a meta-analysis of 5 unselected, population-based cohort studies assessing the risk of cancer among patients with pediatric-onset IBD. These studies were sourced from MEDLINE and Embase from the inception of the database to October 31, 2021. Researchers evaluated the relative rate of cancer overall, as well as by IBD subtype, sex, and exposure to thiopurine.

The 5 studies included 19,812 individuals with pediatric-onset IBD, followed up for 283,540 person-years. Of these individuals, 715 cases of cancer were identified. The authors noted that the “meta-analysis of pooled relative rates showed a 2.4-fold increased rate of cancer among patients with pediatric-onset IBD (pRR, 2.46; 95% CI, 2.06-2.93), seen among patients with Crohn disease (pRR, 2.03; 95% CI, 1.67-2.46) and those with ulcerative colitis (pRR, 2.61; 95% CI, 2.00-3.40).” They also stated that the increased rate was mostly attributed to an increased rate of liver, colorectal, and small bowel cancers. The authors added that “the incidence rate of cancer among patients with pediatric-onset IBD was reported by 4 studies and ranged from 1.0 to 3.3 cases per 1000 person-years.”

The researchers suggested that it may be beneficial to identify variables that modulate cancer risk in pediatric patients, to target prevention and screening.

—Allison Casey

Reference:
Elmahdi R, Lemser CE, Thomsen SB, et al. Development of cancer among patients with pediatric-onset inflammatory bowel disease: A meta-analysis of population-based studies. JAMA Netw Open. 2022;5(3):e220595. doi:10.1001/jamanetworkopen.2022.0595