Solid extraintestinal malignancies in patients with inflammatory bowel disease

Table 4 Studies on prostate cancer in patients with inflammatory bowel disease

Ref.	Country	Type of study	Patients	Results	Limitations
Karlén et al[40], 1999	Sweden	Cohort (1955-1989)	1547 UC	UC 7/1547; SIR 0.7 (0.3-1.5)	Missing data. Closer monitoring of UC patients may lead to higher frequency and early detection
Bernstein et al[39], 2001	Canada	Cohort (1984 -1997)	5529 IBD-1151000 controls	IBD 26/5529 SIR 0.86 (0.59-1.26), 6293/1151000 controls	Possible confounding factor is socioeconomic status. Maximum F.U 14 yr. Data not analyzed by extend of disease
Winther et al[145], 2004	Denmark	Cohort (1962-1997)	1160 UC patients; F.U. median 19 yr	4/1160 UC; UC SMR 0.74 (0.20-1.88)	The treatment principles remained unchanged during the entire follow-up period
Hemminki et al[84], 2012	Sweden	Cohort (1964-2004)	27606 UC patients	UC 277/27606 SIR 1.14 (1.01-1.28), All + 1; SIR 1.08 (0.95-1.22)	Possible incidental finding of PC in older UC patients
Hemminki et al[83], 2009	Sweden	Cohort (1964-2004)	21788 CD patients	CD 152/21788; SIR 1.19 (1.01-1.4), All + 1 SIR 1.12 (0.94-1.32)	The sparseness of individual cancers did not allow conclusions about the trends
Jess et al[75], 2013	Denmark	Cohort (1978-2010)	1437 UC; 774 CD	UC SIR 1.82 (1.17-2.71)	No detailed pharmaco-epidemiological analysis
Jussila et al[30], 2013	Finland	Cohort (1987-1993 and 2000-2007)	21964 IBD (16649 UC; 5315 CD); 5351000 controls	IBD 176/21964; 51045/5351000 controls; IBD SIR 0.84 (0.73-0.97) UC 150/16649 SIR 0.85 (0.72-0.99) P < 0.05; CD 26/5315 SIR 0.79 (0.52-1.16)	Possibility of mis-classification of IBD, CD, UC, and Ca. Patients diagnosed 1987-1993 and 2000-2007 were only included
Kappelman et al[35], 2014	Denmark	Cohort (1978-2010)	42717 IBD (35152 UC; 13756 CD); 5554844 controls. F.U. CD for 7.6 yr, UC for 7.8 yr	IBD 316/42717; controls 33960/5554844. IBD SIR 1.21 (1.08-1.35); UC 258/35152 SIR 1.2 (1.1-1.4); CD 58/13756 SIR 1.2 (0.9-1.6)	No age-estimates of absolute cancer risk. Detection bias. Data possibly missing. No inpatient encounters prior to 1995
Wilson et al[36], 2016	Switzerland	Case-control (1995-2012)	19647 IBD (7850 CD; 11797 UC); 19647 controls	IBD 79/19647; 67/19647 controls. IBD aHR 1.19 (0.86-1.65); CD 17/7850; 16/7850 controls; CD aHR 1.08 (0.54-2.15); UC 62/11797; 51/11797 controls UC aHR 1.22 (0.84-1.77)	Exposure misclassification. Potential bias in multivariate analysis (smoking, alcohol, BMI)
Jung et al[31], 2017	Korea	Cohort (2011-2014)	9785 UC; 5506 CD; 50750000 controls	19/15291 IBD; 20607/50750000 controls. IBD SIR 3.5 (2.1-5.5); UC SIR 3.47 (2.06-5.48); CD SIR O.99 (0.03-5.54)	The study did not focus on IBD treatment. Data for disease diagnosis, phenotype not available. Short follow-up
So et al[29], 2017	China	Cohort (1990-2016)	2621 IBD; 1603 UC; 7392000 controls. Median F.U. 8 yr CD, 10 yr UC	8/2621 IBD; 11115/7392000 controls. IBD SIR 2.03 (1.03-4.06); 8/1603 UC; UC SIR 2.47 (1.24-4.95)	The 25% of the cohort was followed up for < 5 yr. Small size of PC cases. Lead-time and detection bias. Exposure not evaluated
Mosher et al[24], 2018	United States	Case-control study Veteran population (1996-2015)	2080 IBD patients; 271898 without IBD	574/2080 IBD; 337/271898 IBD free; 20 yr RR 1.70 (1.28-2.27)	Administrative data. Heterogeneity of the Ca types. Ca incidence rates may be underestimated
Burns et al[146], 2019	United States	Cohort (1996-2017)	1033 IBD; 9306 IBD free	IBD 30/1033; IBD free 29/9306, 10 yr HR 4.44 (2.98-6.62) P < 0.001; clinically significant PC: 10 yr HR 3.72 (2.15-6.42) P < 0.001; RR 9.32 (5.62-15.46)	Variables for IBD missing. Academic medical centre. PC morbidity, mortality, IBD treatments and healthcare utilization not assessed
Meyers et al[147], 2020	United States	Prospective Population-based United Kingdom Biobank cohort (2006 and 2010, with follow-up through mid-2015)	2311 IBD (1488 UC; 643 CD); 215773 IBD free; Men aged 40 to 69 at study entry	UC 49/1488; aHR 1.47 (1.11-1.95) P = 0.0070, ≤ 20 yr: 1.29 (0.89, 1.85), > 20 yr: 1.87 (1.21-2.91) P = 0.0052, BMI ≤ 30: 1.48 (1.07, 2.03), BM1 > 30: 1.35 (0.72, 2.51); CD 14/643 aHR 1.06 (0.63-1.80), ≤ 20 yr: 1.11 (0.58, 2.14), > 20 yr: 0.98 (0.41, 2.37), BMI ≤ 30: 0.83 (0.43, 1.59), BMI > 30: 2.25 (0.93, 5.41)	Number of prior PSA test, DRE, PC morbidity and mortality and IBD treatments were not reported. No data for PC grade or stage. Selection bias

IBD: Inflammatory bowel disease; Ca: Cancer; PC: Prostate cancer; UC: Ulcerative colitis; SIR: Standardized incidence ratio; CD: Crohn’s disease; SMR: Standardized mortality ratio; All + 1: Diagnosis of cancer later than the first year of IBD diagnosis; F.U.: Follow-up; AHR: Adjusted hazard ratio; DRE: Digital rectal examination; BMI: Body mass index; PSA: Prostate-specific antigen.