Total and cancer mortality in a cohort of Ulcerative Colitis and Crohn's Disease patients: the Florence Inflammatory Bowel Disease Study, 1978-2010

• Published in: Digestive and liver disease 2016-10, Vol.48 (10), p.1162-1167
• Main Authors: Caini, Saverio, Bagnoli, Siro, Palli, Domenico, Saieva, Calogero, Ceroti, Marco, Bendinelli, Benedetta, Assedi, Melania, Masala, Giovanna
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Alzheimer Disease - mortality; Brain Neoplasms - mortality; Cancer mortality; Cause of Death; Colitis, Ulcerative - mortality; Crohn Disease - mortality; Crohn's disease; Female; Gastroenterology and Hepatology; Hodgkin Disease - mortality; Humans; Inflammatory bowel diseases; Italy; Male; Middle Aged; Rectal Neoplasms - mortality; Registries; Respiratory Tract Diseases - mortality; Ulcerative colitis
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2016.07.008

Abstract Background : There is no consensus on the leading causes of death among inflammatory bowel diseases (IBD) patients. Aim : We present the results of an extended follow-up of the population-based Florence IBD cohort, including 689 ulcerative colitis and 231 Crohn's disease patients. Methods : The causes of death of cohort members were determined through linkage with the local mortality registry. We calculated standardized mortality ratios (SMR) and 95% confidence intervals (95%CI) by applying gender-, age- and calendar time- death rates to person-years at risk. Results : Ulcerative colitis patients had overall mortality comparable to the general population (SMR 0.99, 95%CI 0.85-1.14), though being at increased risk of dying from Hodgkin's disease (SMR 11.74, 95%CI 2.94-46.94), rectal cancer (SMR 3.69, 95%CI 1.66-8.22) and Alzheimer's disease (2.40, 95%CI 1.00-5.76). Crohn's disease patients had an increased overall mortality (SMR 1.79, 95%CI 1.39-2.27) and were at higher risk of dying from cancer (SMR 2.57, 95%CI 1.28-5.13) and non-cancer diseases of the respiratory system (SMR 2.51, 95%CI 1.05-6.04), brain cancer (SMR 6.26, 95%CI 1.57-25.02) and non-cancer diseases of the genitourinary system (SMR 4.38, 95%CI 1.10-17.52). Conclusions : IBD patients should be offered counselling on risk reduction strategies, as much of their mortality excess is potentially avoidable.