Development of Cancer Among Patients With Pediatric-Onset Inflammatory Bowel Disease: A Meta-analysis of Population-Based Studies.
Development of Cancer Among Patients With Pediatric-Onset Inflammatory Bowel Disease: A Meta-analysis of Population-Based Studies.
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DOI：
10.1001/jamanetworkopen.2022.0595
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发表时间：
2022-03-01
影响因子：
13.8
通讯作者：
Jess T
中科院分区：
文献类型：
--
作者：
Elmahdi R;Lemser CE;Thomsen SB;Allin KH;Agrawal M;Jess T
儿童期炎症性肠病（IBD）患者患癌症的风险是多少？这项荟萃分析包括19，812名个体的500项基于人群的队列研究发现，儿童发病IBD患者的癌症发病率增加了2.4倍，这主要是由于胃肠道癌症。儿童期IBD患者的癌症绝对发病率较低。这些结果表明，与一般儿科人群相比，儿童发病IBD患者的癌症发生率增加了2倍以上，主要是由于胃肠道癌症的发生率增加。由于儿童发病的炎症性肠病（IBD）的发病率正在增加，因此需要了解该患者人群的长期癌症风险。评估儿童期IBD患者中癌症的相对发生率。对MEDLINE和Embase进行了从数据库建立之日至2021年10月31日的全面系统检索。纳入了所有评估癌症风险的儿童发病IBD的基于人群的队列研究。排除了三级中心转诊和保险数据库研究。所有文章均由2名独立评审员进行评估。本研究遵循系统性综述和荟萃分析的首选报告项目报告指南进行数据提取，并使用Newcastle-Ottawa量表评估偏倚风险和纳入文章的质量。使用逆方差法对纳入研究进行随机效应模型荟萃分析，以评估总体癌症相对发生率以及IBD亚型（克罗恩病或溃疡性结肠炎）、性别和儿童期IBD患者的硫嘌呤暴露。计算合并研究的合并相对率（pRR）沿着和95% CI。在筛选的4628篇文章中，来自北美和欧洲的5项基于人群的研究符合纳入条件。这些研究包括19812例儿童期IBD患者，随访283540人-年，其中715例癌症病例被确定。pRR估计值的荟萃分析显示，儿童期IBD患者的癌症发生率增加了2.4倍（pRR，2.46; 95% CI，2.06-2.93），见于克罗恩病患者（pRR，2.03; 95% CI，1.67-2.46）和溃疡性结肠炎患者（pRR，2.61; 95% CI，2.00-3.40）。该发生率增加主要是由于肝癌（pRR，55.45; 95% CI，19.59-156.99）、结直肠癌（pRR，20.29; 95% CI，15.90-25.90）和小肠癌（pRR，16.20; 95% CI，3.52-74.66）发生率增加。4项研究报告了儿童期IBD患者的癌症发生率，范围为1.0 - 3.3例/1000人-年。这项基于人群的研究的荟萃分析显示，与一般儿科人群相比，儿科发病IBD患者的癌症发病率增加了2倍以上，主要是由于胃肠道癌症的发病率增加。这项荟萃分析评估了儿童发病的炎症性肠病（IBD）患者中癌症的相对发病率。
What is the risk of cancer among patients with pediatric-onset inflammatory bowel disease (IBD)? This meta-analysis of 5 unselected, population-based cohort studies comprising 19 812 individuals found a 2.4-fold increased rate of cancer among patients with pediatric-onset IBD, which was primarily due to gastrointestinal cancers. The absolute rate of cancer among patients with pediatric-onset IBD is low. These results suggest that there is a greater than 2-fold increased rate of cancer among patients with pediatric-onset IBD compared with general pediatric populations, due primarily to an increased rate of gastrointestinal cancers. Because the incidence of pediatric-onset inflammatory bowel disease (IBD) is increasing, knowledge of the long-term risk of cancer in this patient population is required. To evaluate the relative rate of cancer among patients with pediatric-onset IBD. A comprehensive systematic search was performed of MEDLINE and Embase from the date of database inception to October 31, 2021. All unselected, population-based cohort studies of pediatric-onset IBD assessing the risk of cancer were included. Tertiary center referrals and insurance database studies were excluded. All articles were assessed by 2 independent reviewers. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline for data extraction and used the Newcastle-Ottawa Scale for assessment of the risk of bias and the quality of included articles. A random-effects model meta-analysis was conducted of included studies using the inverse-variance method to assess the relative rate of cancer overall and by IBD subtype (Crohn disease or ulcerative colitis), sex, and thiopurine exposure among patients with pediatric-onset IBD. Pooled relative rates (pRRs) along with 95% CIs were calculated for combined studies. Of 4628 articles screened, 5 population-based studies from North America and Europe were eligible for inclusion. These studies comprised 19 812 individuals with pediatric-onset IBD followed up for 283 540 person-years in which 715 cases of cancer were identified. Meta-analysis of pRR estimates 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). This increased rate is primarily due to an increased rate of liver (pRR, 55.45; 95% CI, 19.59-156.99), colorectal (pRR, 20.29; 95% CI, 15.90-25.90), and small bowel (pRR, 16.20; 95% CI, 3.52-74.66) cancers. 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. This meta-analysis of unselected, population-based studies showed a greater than 2-fold increased rate of cancer among patients with pediatric-onset IBD compared with the general pediatric populations, primarily owing to an increased rate of gastrointestinal cancers. This meta-analysis evaluates the relative rate of cancer among patients with pediatric-onset inflammatory bowel disease (IBD).
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DOI：
10.1038/ajg.2017.97
发表时间：
2017-07
期刊：
The American journal of gastroenterology
影响因子：
--
作者：
Benchimol EI;Bernstein CN;Bitton A;Carroll MW;Singh H;Otley AR;Vutcovici M;El-Matary W;Nguyen GC;Griffiths AM;Mack DR;Jacobson K;Mojaverian N;Tanyingoh D;Cui Y;Nugent ZJ;Coulombe J;Targownik LE;Jones JL;Leddin D;Murthy SK;Kaplan GG
通讯作者：
Kaplan GG
影响因子：
8
作者：
Rahier, J. F.;Magro, F.;Colombel, J. F.
通讯作者：
Colombel, J. F.
影响因子：
5
作者：
Bernstein, CN;Blanchard, JF;Wajda, A
通讯作者：
Wajda, A
影响因子：
9.8
作者：
Peneau, Anais;Savoye, Guillaume;Gower-Rousseau, Corinne
通讯作者：
Gower-Rousseau, Corinne
DOI：
10.1136/bmj.j3951
发表时间：
2017-09-20
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Olén O;Askling J;Sachs MC;Frumento P;Neovius M;Smedby KE;Ekbom A;Malmborg P;Ludvigsson JF
通讯作者：
Ludvigsson JF