Risk for Numerous Cancers Increased in Ulcerative Colitis

NEW YORK SEPT 18, 2008 (Reuters Health) - Patients with ulcerative colitis have an increased risk of developing a number of types of cancer, according to findings published in the September 15th issue of the International Journal of Cancer.

It"s known that ulcerative colitis (UC) patients are at an increased risk of colorectal and hepatobiliary cancers, nonmelanoma skin cancers, and acute myeloid leukemia, note the authors. However, they reasoned that because UC is an autoimmune disease, the range of cancer risks is possibly much wider.

To investigate, Dr. Kari Hemminki, of the German Cancer Research Center, Heidelberg, Germany, and colleagues at the Karolinska Institute in Huddinge, Sweden, linked UC patients identified from the Swedish Hospital Discharge Register with cancer patients from the Cancer Registry.

A total of 27,606 UC patients were hospitalized for the first time during the period 1964 to 2004. Of these, 2058 patients developed cancer, for an overall standardized incidence ratio (SIR) of 1.46 and a SIR of 1.29 for cancer diagnosed later than 1 year after UC hospitalization.

Overall, 11 sites exhibited an increased cancer risk, but only six sites remained when limited to occurrence at least a year after UC hospitalization.

A number of novel tumor sites were identified in this population, including small intestine, pancreas, breast, prostate, nonthyroid endocrine glands, non-Hodgkin lymphoma, and multiple myeloma.

The authors note that the risk of cancer depended on the age at first hospitalization for UC. "Colon, rectal, liver, and pancreatic cancers were increased mostly in those hospitalized before the age of 25 years and the SIRs were particularly high in liver (35.09) and colon cancers (20.41)," Dr. Hemminki and colleagues report. "Endocrine tumors showed the highest SIRs in those hospitalized at ages over 64 years."

They point out, however, that some of the apparent increased risk may be because of intensified medical surveillance of UC patients.

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