Increasing Risk of Lymphoma Over Time in Crohn's Disease but Not in Ulcerative Colitis: A Scandinavian Cohort Study

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Increasing Risk of Lymphoma Over Time in Crohn's Disease but Not in Ulcerative Colitis : A Scandinavian Cohort Study

Olén, Ola (författare): Karolinska Institutet,Karolinska Inst, Sweden; Stockholm South Gen Hosp, Sweden; Karolinska Inst, Sweden; Karolinska Univ Hosp Solna, Sweden

Smedby, Karin E. (författare): Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden

Erichsen, Rune (författare): Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Surgery, Randers Regional Hospital, Randers, Denmark,Aarhus Univ Hosp, Denmark; Randers Reg Hosp, Denmark

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Pedersen, Lars (författare): Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark,Aarhus Univ Hosp, Denmark

Halfvarson, Jonas, 1970- (författare): Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden,Örebro Univ, Sweden

Hallqvist-Everhov, Åsa (författare): Karolinska Institutet,Karolinska Inst, Sweden

Bryder, Nicklas (författare): Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden

Olsson, Malin (författare): Linköpings universitet,Institutionen för biomedicinska och kliniska vetenskaper,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US

Myrelid, Pär, 1970- (författare): Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US,The Swedish Inflammatory Bowel Disease Quality Register (SWIBREG) Study Group

Hjortswang, Henrik, 1966- (författare): Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Mag- tarmmedicinska kliniken,The Swedish Inflammatory Bowel Disease Quality Register (SWIBREG) Study Group

Bengtsson, J. (författare): Department of Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden

Strid, H. (författare): Department of medicine Solna, Karolinska Institutet, Stockholm, Sweden

Andersson, M. (författare): Department of Internal Medicine, Södra Älvsborgs Hospital, Borås, Sweden

Jäghult, S. (författare): Stockholm Gastro Center, Karolinska Institutet, Stockholm, Sweden

Eberhardson, M. (författare): Department of Gastroenterology, County Council of Östergötland and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

Nordenvall, C. (författare): Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

Björk, J. (författare): Department of medicine Solna, Karolinska Institutet, Stockholm, Sweden

Rejler, Martin (författare): Jönköping University,The Jönköping Academy for Improvement of Health and Welfare,Department of Medicine, Höglandssjukhuset Eksjö, Region Jönköping County Council, Jönköping, Sweden

Grip, O. (författare): Department of Gastroenterology, Skåne University Hospital, Malmö, Sweden

Fagerberg, U. L. (författare): Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden

Karling, P. (författare): Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

Askling, J. (författare): Karolinska Institutet,Karolinska Inst, Sweden

Ekbom, A. (författare): Karolinska Institutet,Karolinska Inst, Sweden

Sachs, M. C. (författare): Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Sweden

Sørensen, H. T. (författare): Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark,Aarhus Univ Hosp, Denmark

Ludvigsson, Jonas F., 1969- (författare): Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Inst, Sweden; Orebro Univ Hosp, Sweden; Columbia Univ, NY USA

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Elsevier, 2023
2023
Engelska.
Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 21:12, s. 3132-3142

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://liu.diva-por... (primary) (Raw object); https://urn.kb.se/re...; https://doi.org/10.1...; https://urn.kb.se/re...; http://kipublication...; https://urn.kb.se/re...; visa färre...

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Abstract Ämnesord

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Background & Aims: Earlier studies have provided varying risk estimates for lymphoma in patients with inflammatory bowel disease (IBD), but often have been limited by detection biases (especially during the first year of follow-up evaluation), misclassification, and small sample size; and rarely reflect modern-day management of IBD.Methods: We performed a binational register-based cohort study (Sweden and Denmark) from 1969 to 2019. We compared 164,716 patients with IBD with 1,639,027 matched general population reference individuals. Cox regression estimated hazard ratios (HRs) for incident lymphoma by lymphoma subtype, excluding the first year of follow-up evaluation.Results: From 1969 to 2019, 258 patients with Crohn's disease (CD), 479 patients with ulcerative colitis (UC), and 6675 matched reference individuals developed lymphoma. This corresponded to incidence rates of 35 (CD) and 34 (UC) per 100,000 person-years in IBD patients, compared with 28 and 33 per 100,000 person-years in their matched reference individuals. Although both CD (HR, 1.32; 95% CI, 1.16–1.50) and UC (HR, 1.09; 95% CI, 1.00–1.20) were associated with an increase in lymphoma, the 10-year cumulative incidence difference was low even in CD patients (0.08%; 95% CI, 0.02–0.13). HRs have increased in the past 2 decades, corresponding to increasing use of immunomodulators and biologics during the same time period. HRs were increased for aggressive B-cell non-Hodgkin lymphoma in CD and UC patients, and for T-cell non-Hodgkin lymphoma in CD patients. Although the highest HRs were observed in patients exposed to combination therapy (immunomodulators and biologics) or second-line biologics, we also found increased HRs in patients naïve to such drugs.Conclusions: During the past 20 years, the risk of lymphomas have increased in CD, but not in UC, and were driven mainly by T-cell lymphomas and aggressive B-cell lymphomas.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

Nyckelord

Crohn's Disease
Elderly IBD
Epidemiology
IBD
IBD Unclassified
IBDU
Inflammatory Bowel Disease
Lymphoid Neoplasm
Lymphoma
Pediatric IBD
Population-Based
Ulcerative Colitis

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Gastroenterologi

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Av lärosätet: Jönköping University; Örebro universitet; Karolinska Institutet; Linköpings universitet

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