Cancer Risk in Patients with Intestinal Behçet’s Disease: A Nationwide Population-Based Study

Abstract

Background/AimsThe relationship between intestinal Behçet’s disease (BD) and cancer remains unclear. We conducted a nationwide, population-based study to determine the risk of cancer in patients with intestinal BD.MethodsUsing the National Health Insurance claims records, we collected data on 365 patients who had been diagnosed with intestinal BD between 2011 and 2014. Standardized incidence ratios (SIRs) of overall and site-specific cancers in patients with intestinal BD in comparison with the general population were calculated.ResultsAmong 167 men with intestinal BD, four cases of cancer were observed; among 191 women with BD, eight cases of cancer were observed. The risk of all cancers was significantly higher in women with intestinal BD than in women of the general population (SIR, 4.27; 95% confidence interval [CI], 1.84 to 8.41). However, in men with intestinal BD, the risk of all cancers was not significantly higher than that in men of the general population (SIR, 2.08; 95% CI, 0.57 to 5.33). The risk of hematologic cancer was significantly higher in both men and women with intestinal BD than in their counterparts in the general population (SIR, 23.90; 95% CI, 2.89 to 86.32 in men; SIR, 34.47; 95% CI, 4.17 to 124.51 in women). In particular, patients with intestinal BD showed a higher risk of leukemia and myelodysplastic syndrome than the general population.ConclusionsPatients with intestinal BD demonstrated a higher risk of hematologic cancer, especially leukemia, than the general population. Furthermore, women with intestinal BD showed a higher risk of all cancers.

Pharmacotherapy for Behçet’s Disease and the Risk of Malignancy

“…To our knowledge, only few studies have mentioned the influence of medication use on the cancer risk. And among these studies the results were not completely convincing due to the limited number of BD patients for statistical power and incomplete medication information (Han et al, 2017;Han et al, 2018). Nonetheless, the relationship between drug exposure and the cancer risk of patients with BD has not yet been systematically analyzed.…”

“…Recently, Korean- and Taiwanese population-based studies have shown that BD patients have a high risk of cancer ( Lin et al, 2014 ; Wang et al, 2015 ; Han et al, 2017 ; Han et al, 2018 ; Na et al, 2018 ). Several possible reasons might be closely related to high cancer risk, including immunosuppressant treatment administered for BD ( Lin et al, 2014 ).…”

“…Previous studies have indicated that treatment with immunosuppressants increased the risk of cancers ( Solomon et al, 2014 ; Brand et al, 2014 ), while Crusz and Balkwill (2015) showed that immunomodulators could reduce cancer risk. Two recent Korean population-based studies reported that three-quarters of BD patients who used thiopurines developed hematological cancer and the use of thiopurines was associated with lower solid and overall cancer risk in BD patients ( Han et al, 2017 ; Han et al, 2018 ). However, given the lack of an adequate number of BD patients with cancer and long-term follow-up duration of aforementioned studies, further investigation is needed.…”

Intestinal Behçet's disease: A review of clinical diagnosis and treatment

“…Due to unsatisfactory control of disease symptoms with empirical medication, intestinal BD can lead to complications, such as anemia[ 22 ], and even increased risk of hematologic malignancies[ 23 ]. Severe cases can cause intestinal perforation or massive gastrointestinal bleeding, necessitating intestinal resection.…”

Berberine a traditional Chinese drug repurposing: Its actions in inflammation-associated ulcerative colitis and cancer therapy

“…In recent years, a series of actions of BBRmediated anti-intestinal diseases, anti-cancer, antioxidative stress, and anti-inflammatory has been reported in vivo and in vitro (5)(6)(7). Indeed, intestinal disorders and cancer are tightly associated and always characterized by inflammation, oxidative stress, and a couple of immune outputs (8). Inflammation response of the body would benefit the recovery when exposed to infection or invasion events.…”