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Effects of Primary Sclerosing Cholangitis on Risks of Cancer and Death in People With Inflammatory Bowel Disease, Based on Sex, Race, and Age
Open accessAbstract
Background & aims There are insufficient population-level data on the effects of primary sclerosing cholangitis (PSC) in patients with inflammatory bowel disease (IBD).Methods We identified incident cases of IBD, with PSC (PSC-IBD) and without, from April 2006 to April 2016 and collected data on outcomes through April 2019. We linked data from national health care registries maintained for all adults in England on hospital attendances, imaging and endoscopic evaluations, surgical procedures, cancer, and deaths. Our primary aim was to quantify the effects of developing PSC in patients with all subtypes of IBD and evaluate its effects on hepatopancreatobiliary disease, IBD-related outcomes, and all-cause mortality, according to sex, race, and age.Results Over 10 years, we identified 284,560 incident cases of IBD nationwide; of these, 2588 patients developed PSC. In all, we captured 31,587 colectomies, 5608 colorectal cancers (CRCs) 6608 cholecystectomies, and 41,055 patient deaths. Development of PSC was associated with increased risk of death and CRC (hazard ratios [HRs], 3.20 and 2.43, respectively; P < .001) and a lower median age at CRC diagnosis (59 y vs 69 y without PSC; P < .001). Compared to patients with IBD alone, patients with PSC-IBD had a 4-fold higher risk of CRC if they received a diagnosis of IBD at an age younger than 40 years; there was no difference between groups for patients diagnosed with IBD at an age older than 60 years. Development of PSC also increased risks of cholangiocarcinoma (HR, 28.46), hepatocellular carcinoma (HR, 21.00), pancreatic cancer (HR, 5.26), and gallbladder cancer (HR, 9.19) (P < .001 for all). Risk of hepatopancreatobiliary cancer-related death was lower among patients with PSC-IBD who received annual imaging evaluations before their cancer diagnosis, compared to those who did not undergo imaging (HR, 0.43; P = .037). The greatest difference in mortality between the PSC-IBD alone group vs the IBD alone group was for patients younger than 40 years (incidence rate ratio >7), in contrast to those who received a diagnosis of IBD when older than 60 years (incidence rate ratio, <1.5). Among patients with PSC-IBD we observed 173 first liver transplants. Liver transplantation and PSC-related events accounted for approximately 75% of clinical events when patients received a diagnosis of PSC at an age younger than 40 years vs 31% of patients who received a diagnosis when older than 60 years (P < .001). African Caribbean heritage was associated with increased risks of liver transplantation or PSC-related death compared with white race (HR, 2.05; P < .001), whereas female sex was associated with reduced risk (HR, 0.74; P = .025).Conclusions In a 10-year, nationwide study, we confirmed that patients with PSC-IBD have increased risks of CRC, hepatopancreatobiliary cancers, and death compared to patients with IBD alone. In the PSC-IBD group, diagnosis of IBD at age younger than 40 years was associated with greater risks of CRC and all-cause mortality compared with diagnosis of IBD at older ages. Patients who receive a diagnosis of PSC at an age younger than 40 years, men, and patients of African Caribbean heritage have an increased incidence of PSC-related events.
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“Data from a population-based registry study shows an association between exposure to annual imaging and a 2-fold reduction in the risk of hepatobiliary cancer-related death.123”
From EASL Clinical Practice Guidelines on sclerosing cholangitis (2022) · cites this paper as [123]
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Purposeful selection of variables in logistic regression
Bursac, Z., Gauss, C. H., Williams, D. K., & Hosmer, D. W. (2008) · Source Code for Biology and Medicine · doi:10.1186/1751-0473-3-17 · Cited by 4,035
Data Resource Profile: Hospital Episode Statistics Admitted Patient Care (HES APC)
Herbert, A., Wijlaars, L., Zylbersztejn, A., Cromwell, D., & Hardelid, P. (2017) · International Journal of Epidemiology · doi:10.1093/ije/dyx015 · Cited by 742
Boonstra, K., Weersma, R. K., van Erpecum, K. J., Rauws, E. A., Spanier, B. W. M., Poen, A. C., van Nieuwkerk, K. M., Drenth, J. P., Witteman, B. J., Tuynman, H. A., et al. (2013) · Hepatology · doi:10.1002/hep.26565 · Cited by 725
Hepatic and extrahepatic malignancies in primary sclerosing cholangitis
Bergquist, A., Ekbom, A., Olsson, R., Kornfeldt, D., Lööf, L., Danielsson, Å., Hultcrantz, R., Lindgren, S., Prytz, H., Sandberg-Gertzén, H., et al. (2002) · Journal of Hepatology · doi:10.1016/s0168-8278(01)00288-4 · Cited by 717
Systematic review of discharge coding accuracy
Burns, E. M., Rigby, E., Mamidanna, R., Bottle, A., Aylin, P. P., Ziprin, P., & Faiz, O. D. (2011) · Journal of Public Health · doi:10.1093/pubmed/fdr054 · Cited by 699
Gregorio, G. (2001) · Hepatology · doi:10.1053/jhep.2001.22131 · Cited by 692
Epidemiology of primary sclerosing cholangitis and primary biliary cirrhosis: A systematic review
Boonstra, K., Beuers, U., & Ponsioen, C. Y. (2012) · Journal of Hepatology · doi:10.1016/j.jhep.2011.10.025 · Cited by 632
Weismüller, T. J., Trivedi, P. J., Bergquist, A., Imam, M., Lenzen, H., Ponsioen, C. Y., Holm, K., Gotthardt, D., Färkkilä, M. A., Marschall, H.-U., et al. (2017) · Gastroenterology · doi:10.1053/j.gastro.2017.02.038 · Cited by 533
Self-citationDecreasing Risk of Colorectal Cancer in Patients With Inflammatory Bowel Disease Over 30 Years
Jess, T., Simonsen, J., Jørgensen, K. T., Pedersen, B. V., Nielsen, N. M., & Frisch, M. (2012) · Gastroenterology · doi:10.1053/j.gastro.2012.04.016 · Cited by 530
Colorectal cancer in ulcerative colitis: a Scandinavian population-based cohort study
Olén, O., Erichsen, R., Sachs, M. C., Pedersen, L. H., Halfvarson, J., Askling, J., Ekbom, A., Sørensen, H. T., & Ludvigsson, J. F. (2020) · The Lancet · doi:10.1016/s0140-6736(19)32545-0 · Cited by 472
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EASL Clinical Practice Guidelines on sclerosing cholangitis
Chazouilleres, O., Beuers, U., Bergquist, A., Karlsen, T. H., Levy, C., Samyn, M., Schramm, C., & Trauner, M. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2022.05.011 · Cited by 419
ECCO Guidelines on Extraintestinal Manifestations in Inflammatory Bowel Disease
Gordon, H., Burisch, J. M., Ellul, P., Κarmiris, K., Katsanos, K., Allocca, M., Bamias, G., Acosta, M. B., Braithwaite, T., Greuter, T., et al. (2023) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjad108 · Cited by 363
ECCO Guidelines on Inflammatory Bowel Disease and Malignancies
Gordon, H., Biancone, L., Fiorino, G., Katsanos, K. H., Kopylov, U., Sulais, E. A., Axelrad, J. E., Balendran, K., Burisch, J. M., de Ridder, L., et al. (2022) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjac187 · Cited by 336
Recent advances in clinical practice: Epidemiology of autoimmune liver diseases
Trivedi, P. J., & Hirschfield, G. M. (2021) · Gut · doi:10.1136/gutjnl-2020-322362 · Cited by 244
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Metadata
- Authors
- Trivedi, P. J., Crothers, H., Mytton, J., Bosch, S., Iqbal, T., Ferguson, J., & Hirschfield, G. M.
- Affiliations
- National Health Service (GB)
- University Hospitals Birmingham NHS Foundation Trust (GB)
- Amsterdam UMC Location University of Amsterdam (NL)
- University Health Network (CA)
- Corresponding author
- Trivedi, Palak J.
- Hirschfield, Gideon M.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2020-09
- Volume
- 159
- Issue
- 3
- Pages
- 915-928
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W3027906267
- Cited by
- 183
- References
- 50
- Citations by year
- 2026: 27 · 2025: 35 · 2024: 29 · 2023: 31 · 2022: 31 · 2021: 25 · 2020: 5
- FWCI
- 13.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by-nc-nd)
- Funders
- University of Birmingham
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Health Sciences › Medicine › Rheumatology › IgG4-Related and Inflammatory Diseases
- Keywords
- primary sclerosing cholangitis, inflammatory bowel disease, colorectal cancer, hepatopancreatobiliary cancer, cholangiocarcinoma, hepatocellular carcinoma, pancreatic cancer, gallbladder cancer, all-cause mortality, cancer risk, age at diagnosis, sex differences, racial disparities, colectomy, cholecystectomy
- MeSH terms
- Adult, Age Factors, Aged, England, Female, Humans, Longitudinal Studies, Male, Middle Aged, Mortality, Neoplasms, Prospective Studies, Registries, Risk Factors, Sex Factors, State Medicine, Cholangitis, Sclerosing, Inflammatory Bowel Diseases, Incidence, Age of Onset, Risk Assessment, Racial Groups, Young Adult
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