Cancer Risk in Patients with Intestinal Behçet’s Disease: A Nationwide Population-Based Study
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Background/Aims: The 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. Methods: Using 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. Results: Among 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. Conclusions: Patients 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.
Abstract
Background/Aims: The 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. Methods: Using 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. Results: Among 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. Conclusions: Patients 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.
참고문헌 (32)
- Dalvi SR, "Behcet's syndrome", Drugs, 72, pp.2223~2241 (2012)[DOI]
- Tadakazu Hisamatsu, "Treatment and outcomes: medical and surgical treatment for intestinal Behçet’s disease", Intestinal research, 15(3), pp.318~327 (2017), 대한장연구학회
- Beyaert R, "Cancer risk in immune-mediated inflammatory diseases (IMID)", Mol Cancer, 12, pp.98~ (2013)[DOI]
- Okada F, "Inflammation-related carcinogenesis: current findings in epidemiological trends, causes and mechanisms", Yonago Acta Med, 57, pp.65~72 (2014)
- Biancone L, "Cancer and immunomodulators in inflammatory bowel diseases", Inflamm Bowel Dis, 21, pp.674~698 (2015)[DOI]
- Turesson C, "Malignancy as a comorbidity in rheumatic diseases", Rheumatology (Oxford), 52, pp.5~14 (2013)[DOI]
- Weng MY, "Incidence of cancer in a nationwide population cohort of 7852 patients with primary Sjogren's syndrome in Taiwan", Ann Rheum Dis, 71, pp.524~527 (2012)[DOI]
- Lin Y, "Behcet's disease associated with malignancy: a report of 41 Chinese cases", Int J Rheum Dis, 17, pp.459~465 (2014)[DOI]
- Ahn JK, "Behcet's disease associated with malignancy in Korea: a single center experience", Rheumatol Int, 30, pp.831~835 (2010)[DOI]
- 나소영, "Morbidity of Solid Cancer in Behçet’s Disease: Analysis of 11 Cases in a Series of 506 Patients", Yonsei Medical Journal, 54(4), pp.895~901 (2013), 연세대학교의과대학[DOI]
- Tada Y, "The association of Behcet's disease with myelodysplastic syndrome in Japan: a review of the literature", Clin Exp Rheumatol, 24(5 Suppl 42), pp.S115~S119 (2006)
- Ahn JK, "Behcet's disease associated with bone marrow failure in Korean patients: clinical characteristics and the association of intestinal ulceration and trisomy 8", Rheumatology (Oxford), 47, pp.1228~1230 (2008)[DOI]
- Cheon JH, "Development and validation of novel diagnostic criteria for intestinal Behcet's disease in Korean patients with ileocolonic ulcers", Am J Gastroenterol, 104, pp.2492~2499 (2009)[DOI]
- 이현정, "Optimal diagnosis and disease activity monitoring of intestinal Behçet’s disease", Intestinal research, 15(3), pp.311~317 (2017), 대한장연구학회
- Kappelman MD, "Risk of cancer in patients with inflammatory bowel diseases: a nationwide population-based cohort study with 30 years of follow-up evaluation", Clin Gastroenterol Hepatol, 12, pp.265~273 (2014)[DOI]
- Lutgens MW, "Declining risk of colorectal cancer in inflammatory bowel disease: an updated meta-analysis of population-based cohort studies", Inflamm Bowel Dis, 19, pp.789~799 (2013)[DOI]
- Ruben J. Colman, "Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review", Intestinal research, 14(3), pp.202~210 (2016), 대한장연구학회
- Han M, "Incidence and clinical outcomes of intestinal Behcet's disease in Korea, 2011-2014: a nationwide population-based study", J Gastroenterol, 52, pp.920~928 (2017)[DOI]
- Seo HJ, "A comparison of the cancer incidence rates between the National Cancer Registry and insurance claims data in Korea", Asian Pac J Cancer Prev, 13, pp.6163~6168 (2012)[DOI]
- Wang LH, "Risk of overall and site-specific cancers in Behcet disease: a nationwide population-based study in Taiwan", J Rheumatol, 42, pp.879~884 (2015)[DOI]
- Yu KH, "Cancer risk in patients with inflammatory systemic autoimmune rheumatic diseases: a nationwide population-based dynamic cohort study in Taiwan", Medicine (Baltimore), 95, pp.e3540~ (2016)[DOI]
- Hamzaoui K, "Cytokine profile in Behcet's disease patients: relationship with disease activity", Scand J Rheumatol, 31, pp.205~210 (2002)[DOI]
- Bardak Y, "The demonstration of serum interleukin 6-8, tumor necrosis factor-alpha, complement, and immunoglobulin levels in Behcet's disease with ocular involvement", Ocul Immunol Inflamm, 12, pp.53~58 (2004)[DOI]
- Voulgarelis M, "Myelodysplasia-associated autoimmunity: clinical and pathophysiologic concepts", Eur J Clin Invest, 34, pp.690~700 (2004)[DOI]
- Hsu HC, "Circulating levels of thrombopoietic and inflammatory cytokines in patients with acute myeloblastic leukemia and myelodysplastic syndrome", Oncology, 63, pp.64~69 (2002)
- Baecklund E, "Lymphoma development in patients with autoimmune and inflammatory disorders: what are the driving forces?", Semin Cancer Biol, 24, pp.61~70 (2014)[DOI]
- Ozdogu H, "Long-term colchicine therapy in a patient with Behcet's disease and acute promyelocytic leukemia", Rheumatol Int, 27, pp.763~765 (2007)[DOI]
- Louzir B, "Erythroleukemia in a patient with Behcet's disease under long-term thalidomide therapy", Ann Med Interne (Paris), 143, pp.479~480 (1992)
- Kaloterakis A, "Adamantiades-Behcet's disease coexisting with acute myeloblastic leukaemia", Br J Dermatol, 137, pp.317~318 (1997)
- Bozi E, "Association of Behcet's disease with hematologic malignancies", Int J Dermatol, 46, pp.333~334 (2007)[DOI]
- Yamada M, "Colon cancer arising in an ulcer scar due to intestinal Behcet's disease", Intern Med, 50, pp.429~432 (2011)[DOI]
- Song I Bae, "Colon Cancer Screening and Surveillance in Inflammatory Bowel Disease", Clinical Endoscopy, 47(6), pp.509~515 (2014), 대한소화기내시경학회