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Annals of Oncology Advance Access published online on September 2, 2008
Annals of Oncology, doi:10.1093/annonc/mdn595
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Cancer risks in Crohn disease patients

K. Hemminki1,2,*, X. Li2, J. Sundquist2 and K. Sundquist2

1 Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
2 Center for Family and Community Medicine, Karolinska Institute, Huddinge, Sweden

* Correspondence to: K. Hemminki, MD, PhD., Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120 Heidelberg, Germany. Tel: 49-6221-421800; Fax: 49-6221-421810. E-mail: k.hemminki{at}dkfz.de

Background: Patients diagnosed with Crohn disease (CD) are known to be at an increased risk of bowel cancers and lymphoma. CD is an autoimmune disease and we hypothesize that the patients are predisposed to a wider spectrum of cancers.

Patients and methods: A CD research database was constructed by identifying hospitalized CD patients from the Hospital Discharge Register and cancer patients from the Swedish Cancer Registry. Follow-up of 21 788 CD patients first hospitalized during the years 1964–2004 identified 1424 cancer cases. Standardized incidence ratios (SIRs) were calculated by comparing cancers in CD patients with subjects without CD.

Results: In addition to the known sites, many additional sites were in excess in CD patients. These included liver, pancreatic, lung, prostate, testicular, kidney and skin (squamous cell) cancers; nonthyroid endocrine tumors and leukemia. The previously established sites showed the highest SIRs; however, SIRs >2.0 were noted for the novel sites of the liver, testis and kidney. For testicular cancer, the SIR of seminoma was 2.74. Cancer risks were influences by age at first hospitalization for CD but whether the age effects were increasing or decreasing depending on the cancer type.

Conclusions: This large study identified many novel subsequent cancers in CD patients.

age at onset, autoimmunity, cancer risk, inflammatory bowel disease, subsequent cancer

Received for publication February 22, 2008. Revision received July 29, 2008. Accepted for publication July 30, 2008.


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