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

TitleCancer risk and chemoprevention in Chinese inflammatory bowel disease patients: a population-based cohort study
Authors
Keywords5- aminosalicylic acid
aspirin
statin
cancer
IBD
Issue Date2020
PublisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/00365521.asp
Citation
Scandinavian Journal of Gastroenterology, 2020, v. 55 n. 3, p. 279-286 How to Cite?
AbstractBackground and aim: Role of 5-aminosalicylic acid (5-ASA), statin and aspirin in reducing cancer risks in inflammatory bowel disease (IBD) remains controversial. We aimed to examine chemo-preventive effects of these drugs in all cancers in IBD in population-based setting. Methods: IBD patients diagnosed between 2000 and 2016 were identified from the Hong Kong IBD Registry and followed from IBD diagnosis until first cancer occurrence. Primary outcome was cancer development ≥6 months after IBD diagnosis. Adjusted hazard ratio (aHR) with 95% confidence interval (CI) was estimated with Cox proportional hazards model. Additional effects of statin and aspirin on chemoprevention were also assessed. Results: Amongst 2103 IBD patients (857 Crohn's disease, 1246 ulcerative colitis; mean age 40.0 ± 15.6; 60.3% male) with 16,856 person-years follow-up, 48 patients (2.3%) developed cancer. The 5-r, 10-r and 15-year (95% CI) cumulative incidence of cancer were 1% (0.6 - 1.5%), 2.8 (2.0 - 3.9%) and 4.8 (3.4 - 6.5%), respectively. Total 1891 (89.9%) and 222 (10.6%) patients have received one or more prescriptions of 5-ASA and statin respectively. In multivariable analysis adjusted for age, gender, smoking status, IBD type and use of other medications, use of 5-ASA or statin was not associated with a reduced risk of cancer development (5-ASA: aHR 1.22, 95% CI: 0.60-2.48, p = .593; statin: aHR 0.48, 95% CI: 0.14-1.59, p = .227). Adding aspirin was not associated with a lowered cancer risk (aHR 1.18, 95% CI: 0.32-4.35, p = .799). Conclusion: Use of 5-ASA was not associated with a lowered cancer risk in Chinese IBD patients. Addition of statin/aspirin provided no additional benefit.Key summaryInflammatory bowel diseases (IBD) including Crohn's disease and ulcerative colitis are associated with increased risk of both intestinal and extra- intestinal cancers.Various medications including 5-aminosalicylate acid (5-ASA), statins and aspirin have been studied for their chemoprevention effects. However, most studies focused on colorectal cancer only and showed conflicting evidence. No studies so far looked at the effects of these medications on all cancer development in IBD.The 5-, 10- and 15-year (95% confidence interval) cumulative incidence of cancer in Chinese IBD patients were 1 (0.6-1.5%), 2.8 (2.0-3.9%) and 4.8 (3.4-6.5%), respectively.Use of 5-ASA was not associated with a lowered cancer risk in Chinese IBD patients. Addition of statin/aspirin provided no additional benefit.
Persistent Identifierhttp://hdl.handle.net/10722/284583
ISSN
2019 Impact Factor: 2.13
2015 SCImago Journal Rankings: 0.891

 

DC FieldValueLanguage
dc.contributor.authorMak, JWY-
dc.contributor.authorSo, J-
dc.contributor.authorTang, W-
dc.contributor.authorYip, TCF-
dc.contributor.authorLeung, WK-
dc.contributor.authorLi, M-
dc.contributor.authorLo, FH-
dc.contributor.authorNg, KM-
dc.contributor.authorSze, SF-
dc.contributor.authorLeung, CM-
dc.contributor.authorTsang, SWC-
dc.contributor.authorShan, EHS-
dc.contributor.authorChan, KH-
dc.contributor.authorLam, BCY-
dc.contributor.authorHui, AJ-
dc.contributor.authorChow, WH-
dc.contributor.authorChan, FKL-
dc.contributor.authorNg, SC-
dc.date.accessioned2020-08-07T08:59:42Z-
dc.date.available2020-08-07T08:59:42Z-
dc.date.issued2020-
dc.identifier.citationScandinavian Journal of Gastroenterology, 2020, v. 55 n. 3, p. 279-286-
dc.identifier.issn0036-5521-
dc.identifier.urihttp://hdl.handle.net/10722/284583-
dc.description.abstractBackground and aim: Role of 5-aminosalicylic acid (5-ASA), statin and aspirin in reducing cancer risks in inflammatory bowel disease (IBD) remains controversial. We aimed to examine chemo-preventive effects of these drugs in all cancers in IBD in population-based setting. Methods: IBD patients diagnosed between 2000 and 2016 were identified from the Hong Kong IBD Registry and followed from IBD diagnosis until first cancer occurrence. Primary outcome was cancer development ≥6 months after IBD diagnosis. Adjusted hazard ratio (aHR) with 95% confidence interval (CI) was estimated with Cox proportional hazards model. Additional effects of statin and aspirin on chemoprevention were also assessed. Results: Amongst 2103 IBD patients (857 Crohn's disease, 1246 ulcerative colitis; mean age 40.0 ± 15.6; 60.3% male) with 16,856 person-years follow-up, 48 patients (2.3%) developed cancer. The 5-r, 10-r and 15-year (95% CI) cumulative incidence of cancer were 1% (0.6 - 1.5%), 2.8 (2.0 - 3.9%) and 4.8 (3.4 - 6.5%), respectively. Total 1891 (89.9%) and 222 (10.6%) patients have received one or more prescriptions of 5-ASA and statin respectively. In multivariable analysis adjusted for age, gender, smoking status, IBD type and use of other medications, use of 5-ASA or statin was not associated with a reduced risk of cancer development (5-ASA: aHR 1.22, 95% CI: 0.60-2.48, p = .593; statin: aHR 0.48, 95% CI: 0.14-1.59, p = .227). Adding aspirin was not associated with a lowered cancer risk (aHR 1.18, 95% CI: 0.32-4.35, p = .799). Conclusion: Use of 5-ASA was not associated with a lowered cancer risk in Chinese IBD patients. Addition of statin/aspirin provided no additional benefit.Key summaryInflammatory bowel diseases (IBD) including Crohn's disease and ulcerative colitis are associated with increased risk of both intestinal and extra- intestinal cancers.Various medications including 5-aminosalicylate acid (5-ASA), statins and aspirin have been studied for their chemoprevention effects. However, most studies focused on colorectal cancer only and showed conflicting evidence. No studies so far looked at the effects of these medications on all cancer development in IBD.The 5-, 10- and 15-year (95% confidence interval) cumulative incidence of cancer in Chinese IBD patients were 1 (0.6-1.5%), 2.8 (2.0-3.9%) and 4.8 (3.4-6.5%), respectively.Use of 5-ASA was not associated with a lowered cancer risk in Chinese IBD patients. Addition of statin/aspirin provided no additional benefit.-
dc.languageeng-
dc.publisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/00365521.asp-
dc.relation.ispartofScandinavian Journal of Gastroenterology-
dc.rightsScandinavian Journal of Gastroenterology. Copyright © Informa Healthcare.-
dc.rightsThis is an electronic version of an article published in [include the complete citation information for the final version of the article as published in the print edition of the journal]. [JOURNAL TITLE] is available online at: http://www.informaworld.com/smpp/ with the open URL of your article.-
dc.subject5- aminosalicylic acid-
dc.subjectaspirin-
dc.subjectstatin-
dc.subjectcancer-
dc.subjectIBD-
dc.titleCancer risk and chemoprevention in Chinese inflammatory bowel disease patients: a population-based cohort study-
dc.typeArticle-
dc.identifier.emailLeung, WK: waikleung@hku.hk-
dc.identifier.authorityLeung, WK=rp01479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1080/00365521.2020.1731760-
dc.identifier.pmid32119788-
dc.identifier.scopuseid_2-s2.0-85081238583-
dc.identifier.hkuros312506-
dc.identifier.volume55-
dc.identifier.issue3-
dc.identifier.spage279-
dc.identifier.epage286-
dc.publisher.placeUnited Kingdom-

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