Mortality and extraintestinal cancers in patients with primary sclerosing cholangitis and inflammatory bowel disease
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Szolovits_Mortality and.pdf
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Author(s)
Ananthakrishnan, Ashwin N.
Cagan, Andrew
Gainer, Vivian S.
Cheng, Su-Chun
Cai, Tianxi
Szolovits, Peter
Shaw, Stanley Y.
Churchill, Susanne
Karlson, Elizabeth W.
Murphy, Shawn N.
Date Issued
September 2014
Journal
Journal of Crohn's and Colitis
Publisher
Elsevier
Citation
Ananthakrishnan, Ashwin N., Andrew Cagan, Vivian S. Gainer, Su-Chun Cheng, Tianxi Cai, Peter Szolovits, Stanley Y. Shaw, et al. “Mortality and Extraintestinal Cancers in Patients with Primary Sclerosing Cholangitis and Inflammatory Bowel Disease.” Journal of Crohn’s and Colitis 8, no. 9 (September 1, 2014): 956–963.
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Author's final manuscript
Abstract
Introduction Primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) frequently co-occur. PSC is associated with increased risk for colorectal cancer (CRC). However, whether PSC is associated with increased risk of extraintestinal cancers or affects mortality in an IBD cohort has not been examined previously.
Methods In a multi-institutional IBD cohort of IBD, we established a diagnosis of PSC using a novel algorithm incorporating narrative and codified data with high positive and negative predictive value. Our primary outcome was occurrence of extraintestinal and digestive tract cancers. Mortality was determined through monthly linkage to the social security master death index.
Results In our cohort of 5506 patients with CD and 5522 patients with UC, a diagnosis of PSC was established in 224 patients (2%). Patients with IBD–PSC were younger and more likely to be male compared to IBD patients without PSC; three-quarters had UC. IBD–PSC patients had significantly increased overall risk of cancers compared to patients without PSC (OR 4.36, 95% CI 2.99–6.37). Analysis of specific cancer types revealed that a statistically significant excess risk for digestive tract cancer (OR 10.40, 95% CI 6.86–15.76), pancreatic cancer (OR 11.22, 95% CI 4.11–30.62), colorectal cancer (OR 5.00, 95% CI 2.80–8.95), and cholangiocarcinoma (OR 55.31, 95% CI 22.20–137.80) but not for other solid organ or hematologic malignancies.
Conclusions PSC is associated with increased risk of colorectal and pancreatobiliary cancer but not with excess risk of other solid organ cancers.
MIT Department
Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science
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DOI of Published Version
https://doi.org/10.1016/j.crohns.2014.01.019
