Table 1.
Summary of the main studies included in the review.
| Study | Location | Setting-design | Follow-up period | Main findings |
|---|---|---|---|---|
| El-Matary (4) | Canada | Population-based with age, sex and location matched controls reporting any cancer | Persons with IBD and their controls were followed for 14,938 and 132,202 persons-years, respectively | 1.7% of childhood-onset IBD developed cancer, as compared with 0.8% of controls HR = 2.00, (95% CI 1.16–3.43), with cancer rates of 114 and 57 per 100,000 person-years, respectively |
| El-Matary (20) | International (54 centers) | Retrospective hospital-based reporting CRC in children with PSC-UC | Median duration of follow up of 5 years | The incidence of colorectal dysplasia/cancer in pediatric PSC-UC was 2.8 cases per 1,000 person-years |
| Olen (21, 22) | Scandinavia | Population-based with age, sex, calendar year, and location matched controls reporting CRC in all age groups including pediatric onset IBD | The study period was from 1969 to 2017 | CRC deaths in those diagnosed with UC before the age of 18 y to be 34.2 (95% CI 18.8–62.2). The risk was also elevated among those with CD |
| Olen (23) | Sweden | Cohort [national patient registry (excluding primary outpatient care)] with age, sex, and location matched controls reporting any cancer including CRC in pediatric-onset IBD | 148,682 patient-years | HR for any cancer: UC: 2.6 (2.3–3.0) CD: 1.7 (1.5–2.1) HR for CRC UC: 33 (23-49) CD: 5.8 (3.2–10) |
| Joosse (24) | European multi-center | Retrospective hospital-based reporting any cancer in pediatric-onset IBD | Estimated 192,625 patient-years | Estimated cancer (any type) incidence of 171 per 1,000,000 |
| Hyams (25) | North American multi-center | Prospective hospital-based reporting any cancer in pediatric-onset IBD | 24,543 patient-years. A total follow up period of 9 year | 15 cancers, eight of which were lymphoma and leukemia, and five hemophagocytic syndrome. Thiopurine exposed: 2.9 vs. Non-exposed: 1.3 |
| Kappelman (26) | Denmark | Cohort using the Danish health care databases reporting any cancer in pediatric-onset IBD | Not clear | SIR for those with CD 2.3 and 2.0 for UC |
| Jess (27) | Denmark | Cohort (Nation-wide Cohort) reporting CRC in all age groups including pediatric-onset IBD (<20 y) | 178 million person-years of follow-up | The relative risk for developing CRC in pediatric PSC-UC was 44 and 2 for CD. CRC did not increase except in those diagnosed with pediatric-onset UC or those with concomitant PSC |
| Peneau (28) | France | Cohort reporting any cancer in pediatric-onset IBD | Median follow up period of 15 years | Nine cancers including two with CRC SIR = 3.0 (1.3–5.9) |
| Ekbom (29) | Sweden | Population-based controlled study reporting CRC in pediatric-onset UC | 4,220 person-years | SIR of CRC in patients diagnosed with UC (0–14 y) was 118.3 (95% CI 63–202.3) |
IBD, inflammatory bowel disease; UC, ulcerative colitis; CD, Crohn disease; CRC, colorectal cancer; PSC, primary sclerosing cholangitis; CI, confidence interval; HR, hazard ratio; SIR, standardized incidence ratio.