Cancer incidence in a population-based cohort of individuals hospitalized with Celiac disease or dermatitis herpetiformis
Cancer incidence in a population-based cohort of individuals hospitalized with Celiac disease or dermatitis herpetiformis
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DOI：
10.1053/gast.2002.36585
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发表时间：
2002-11-01
期刊：
影响因子：
29.4
通讯作者：
Ekbom, A
中科院分区：
文献类型：
--
作者：
Askling, J;Linet, M;Ekbom, A
背景和目标：乳糜泻（CD）或疱疹样皮炎（DH）的癌症风险研究表明，恶性淋巴瘤和偶尔其他肿瘤的风险增加，但其特征是数量少，缺乏系统的癌症评估，受试者从转诊机构确定。研究方法：通过使用瑞典基于人群的住院和癌症登记数据，我们随访了12，000例CD或DH受试者，并使用标准化发病率比（SIR）评估癌症发病率。结果如下：CD成人（但不是儿童和青少年）患癌症的总体风险升高（SIR = 1.3），随时间推移而下降，最终达到统一。发现恶性淋巴瘤、小肠癌、口咽癌、食管癌、大肠癌、肝胆癌和胰腺癌的风险升高。恶性淋巴瘤的过度发生仅限于成年人，随着随访评估的时间减少，并在连续的日历期间减少。发现乳腺癌的风险降低。由于恶性淋巴瘤和白血病的过度，DH受试者的总体癌症风险略有增加（SIR = 1.2），但胃肠道癌没有增加。结论：虽然增加，但本研究中淋巴瘤和胃肠道癌的相对风险低于（并下降）大多数以前的报告。总体癌症风险仅适度增加，并且在儿童和青少年时期并未升高。
Background & Aims: Studies of cancer risk in celiac disease (CD) or dermatitis herpetiformis (DH) indicate increased risks for malignant lymphoma and occasionally other neoplasms, but are characterized by small numbers, lack of systematic cancer assessment, and subjects identified from referral institutions. Methods: By using Swedish population-based inpatient and cancer registry data, we followed-up 12,000 subjects with CD or DH, and evaluated cancer incidence by using standardized incidence ratios (SIR). Results: Adults (but not children and adolescents) with CD had an elevated overall risk for cancer (SIR = 1.3) that declined with time and eventually reached unity. Elevated risks were found for malignant lymphomas, small-intestinal, oropharyngeal, esophageal, large intestinal, hepatobiliary, and pancreatic carcinomas. The excess occurrence of malignant lymphomas was confined to adults, decreased with time of follow-up evaluation, and decreased over successive calendar periods. Decreased risks were found for breast cancer. Subjects with DH had a slightly increased overall cancer risk (SIR = 1.2) owing to excesses of malignant lymphoma and leukemia, but no increases of gastrointestinal carcinomas. Conclusions: Albeit increased, the relative risks for lymphomas and gastrointestinal cancers in this study are lower (and declining) than in most previous reports. The overall cancer risk is only moderately increased, and nonelevated during childhood and adolescence.