Cancer risk and chemoprevention in Chinese inflammatory bowel disease patients: a population-based cohort study

Mak, Joyce Wing Yan; So, Jacqueline; Tang, Whitney; Yip, Terry Cheuk‐Fung; Leung, Wai Keung; Lo, Fu Hang; Ng, Ka Man; Sze, Shun Fung; Leung, Chi Man; Tsang, Steven Woon Choy; Shan, Edwin Hok Shing; Chan, Kam Hon; Lam, Belsy C Y; Hui, Aric Josun; Chow, Wai Hung; Chan, Francis K.L.; Ng, Siew C.

doi:10.1080/00365521.2020.1731760

Cited by 12 publications

(11 citation statements)

References 31 publications

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“…IBD including CD and UC is associated with increased risk of intestinal and extraintestinal cancers (6)(7)(8)(9)(10)(11). Local and systemic inflammation were postulated to contribute to the increased risk of cancer in IBD patients (31). Given scarce population-based data about the risk of urinary tumors, we conducted this meta-analysis to illuminate the relationship between IBD and risk of urologic cancers to provide patient consultation and guide clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory bowel disease and risk of urinary cancers: a systematic review and pooled analysis of population-based studies

et al. 2021

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Background: The aim of this study is to elucidate the risk of urologic cancers in patients with Crohn's disease (CD) and ulcerative colitis (UC).Methods: Electronic databases including PubMed, the Cochrane Library, Embase and Web of Science, and manual retrieval were conducted from inception to June 2020. Two reviewers independently searched the above databases and selected the studies using prespecified standardized criteria. The Newcastle-Ottawa Scale was used to assess the risk of bias in the included studies, and this meta-analysis was completed by STATA version 14.2.Results: A total of 12 cohort studies and 4 case-control studies were included in this meta-analysis. Overall, patients with inflammatory bowel disease (IBD) were at significantly increased risk of renal cancer (RCa)[standardized incidence ratio (SIR): 1.53; 95% confidence interval (CI): 1.25-1.80; I 2 =42.4%], but not at increased risk of prostate cancer (PCa), bladder cancer (BCa) and male genital cancer. In the subgroup analysis, CD patients had a significantly higher RCa risk (SIR: 1.95; 95% CI: 1.45-2.44; I 2 =39.9%). Besides, CD patients seemed to be at borderline significantly increased risks of PCa (SIR: 1.07; 95% CI: 0.93-1.20; I 2 =15.1%) and BCa (SIR:1.19; 95% CI: 0.94-1.44; I 2 =0%), and UC patients seemed to be at borderline significantly increased risks of RCa (SIR:1.31; 95% CI: 0.94-1.67; I 2 =48.0%) and PCa (SIR: 1.13; 95% CI: 0.93-1.33; I 2 =73.5%). Notably, we observed that IBD patients in Eastern countries have significantly increased PCa risk (SIR: 2.66; 95% CI: 1.52-3.81; I 2 =13.6%), especially for UC patients (SIR: 3.01; 95% CI: 1.75-4.27; I 2 =0.0%). Conclusions:Our findings indicate that IBD patients with special reference to CD patients increase the risk of RCa. Besides, IBD patients in Asian countries have significantly increased risk of PCa, especially for UC patients. Further studies are warranted to elucidate the potential mechanism of RCa associated with IBD and the differences of the risk of urinary cancers between Eastern and Western countries.

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Section: Discussionmentioning

confidence: 99%

Inflammatory bowel disease and risk of urinary cancers: a systematic review and pooled analysis of population-based studies

et al. 2021

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“…The anti-inflammatory effects of mesalazine are well documented, but its direct chemopreventive effects have been harder to demonstrate, especially in population based studies. [20][21][22] However, a recent meta-analysis showed a protective effect of mesalazine on colorectal cancer [CRC] development even in population-based studies. 23 The effect was dose-dependent.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Ulcerative Colitis 20 Years after Diagnosis in a Prospective Population-based Inception Cohort from South-Eastern Norway, the IBSEN Study

Monstad

Solberg

Cvancarova

et al. 2020

Journal of Crohn's and Colitis

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Background & aims The long-term course of ulcerative colitis (UC) is difficult to predict. Mortality, colectomy, cancer and hospitalization represent hard outcomes of disease. Moreover, knowledge on the risk of relapses and need for potent medication add important information about living with UC. We aimed to evaluate the course and prognosis of UC during the first 20 years after diagnosis and to identify early prognostic risk factors. Methods From 1990 to 1994 a population-based inception cohort of patients with inflammatory bowel disease was enrolled in South Eastern Norway. A systematic follow up (FU) was conducted at 1,5, 10 and 20 years after diagnosis. Clinical outcomes were recorded continuously and possible relationships between early disease characteristics and outcomes were analyzed using multiple regression analysis. Results Among 519 UC patients, 119 died, 60 were lost to FU and 340 included in the FU cohort. The 20-year cumulative risk of colectomy was 13.0% (95% CI [11.4 -14.6]). Extensive colitis at diagnosis was independently associated with an increased risk of colectomy compared with proctitis (hazard ratio (HR)=2.8, 95% CI [1.3-6.1]). In contrast, mucosal healing at one year FU was independently associated with reduced risk of colectomy (HR= 0.4, 95% CI [0.2-0.8]), and inversely associated with subsequent risk of relapse (adjusted HR= 0.5, 95% CI [0.3-0.7]). Conclusions The overall risk of colectomy in our cohort was lower than expected from previous studies, although considerable for patients with extensive colitis at diagnosis. Early mucosal healing was associated with better disease outcomes 20 years after diagnosis

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“…100 Statins were found to reduce CAC in IBD patients in one study 101 but not in another study. 102 Among natural antioxidants, vitC reduces oxidative DNA damage by neutralizing mutagenic ROS and RNI 3,103 and protects from inflammation-associated tumorigenesis in different animal models of CAC. 3 Paradoxically, a prooxidant role for vitC has also been reported at high doses or in presence of transition metals.…”

Section: Testing Exogenous Antioxidants In Cacmentioning

confidence: 99%

Preventing Colitis-Associated Colon Cancer With Antioxidants: A Systematic Review

Irrazábal

Thakur

Croitoru

et al. 2021

Cellular and Molecular Gastroenterology and Hepatology

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Inflammatory bowel disease (IBD) patients have an increased risk of developing colitis-associated colon cancer (CAC); however, the basis for inflammation-induced genetic damage requisite for neoplasia is unclear. Several studies have shown that IBD patients have signs of increased oxidative damage, which could be a result of genetic and environmental factors such as an excess in oxidant molecules released during chronic inflammation, mitochondrial dysfunction, a failure in antioxidant capacity, or oxidant promoting diets. It has been suggested that chronic oxidative environment in the intestine leads to the DNA lesions that precipitate colon carcinogenesis in IBD patients. Indeed, several preclinical and clinical studies show that different endogenous and exogenous antioxidant molecules are effective at reducing oxidation in the intestine. However, most clinical studies have focused on the short-term effects of antioxidants in IBD patients but not in CAC. This review article examines the role of oxidative DNA damage as a possible precipitating event in CAC in the context of chronic intestinal inflammation and the potential role of exogenous antioxidants to prevent these cancers.

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Cancer risk and chemoprevention in Chinese inflammatory bowel disease patients: a population-based cohort study

Cited by 12 publications

References 31 publications

Inflammatory bowel disease and risk of urinary cancers: a systematic review and pooled analysis of population-based studies

Inflammatory bowel disease and risk of urinary cancers: a systematic review and pooled analysis of population-based studies

Outcome of Ulcerative Colitis 20 Years after Diagnosis in a Prospective Population-based Inception Cohort from South-Eastern Norway, the IBSEN Study

Preventing Colitis-Associated Colon Cancer With Antioxidants: A Systematic Review

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