A Population-Based Matched Cohort Study of Digestive System Cancer Incidence and Mortality in Individuals With and Without Inflammatory Bowel Disease

Sep 21, 2026

Uploaded by Skyler

Population-level administrative and cancer registry data from Ontario (1994–2020) were used to compare individuals with inflammatory bowel disease (IBD) with matched controls (1:10 by sex and birth year). Trends in age-sex standardized cancer incidence and cancer-related mortality were assessed through risk ratios for incident cancers and death rates. Colorectal cancer incidence declined similarly in IBD and controls, while small bowel, extraintestinal digestive cancers, and selected hepatobiliary sites rose faster in IBD. Beyond 2010, incidence (and mortality) for colorectal, small bowel, bile duct, and pancreatic cancers was higher in people with IBD than in controls.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

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Introduction

Methods

Results

Discussion

Keywords

ARTICLE 2275 A Population-Based Matched Cohort Study of Digestive System Cancer Incidence and Mortality in Individuals With and Without Inflammatory Bowel Disease Sanjay K. Murthy, MD, MSc1 ,2 ,3 ,4, Parul Tandon, DO4 ,5, Priscilla Matthews, MD6, Faria Ahmed, MSc3, Michael Pugliese, MSc4 , Monica Taljaard, PhD3 ,4, Gilaad G. Kaplan, MD, MPH7, Stephanie Coward, PhD7, Charles Bernstein, MD, FACG8 ,9 , Eric I. Benchimol, MD, PhD4 , 10 , 11 , 12, M. Ellen Kuenzig, PhD10 , 11, Laura E. Targownik, MD, MSHS13 , 14 and Harminder Singh, MD, MPH, FACG8 ,9 , 15, on behalf of the Canadian Gastro-Intestinal Epidemiology Consortium (CanGIEC) INTRODUCTION: To study digestive system cancer risks in individuals with inflammatory bowel diseases (IBDs) in the biologic era. METHODS: We used population-level administrative and cancer registry data from Ontario, Canada,(1994–2020) to compare people with IBD to matched controls (1:10 by sex and birth year) on trends in age-sex standardized cancer incidence and risk ratios of incident cancers and cancer-related deaths. RESULTS: Among 110,919 people with IBD and 1,109,190 controls, colorectal cancer incidence (per 100,000 person-years) declined similarly in people with ulcerative colitis (average annual percentage change [AAPC] 21.81; 95% confidence interval [CI] 22.48 to 21. 156) and controls (AAPC 22.79; 95% CI 23.44 to 22. 14), while small bowel cancer incidence rose faster in those with Crohn’s disease (AAPC 9.68; 95% CI 2.51–17.3) than controls (AAPC 3.64; 95% CI 1.52–5.80) . Extraintestinal digestive cancer incidence rose faster in people with IBD (AAPC 3.27; 95% CI 1.83–4.73) than controls (AAPC 21.87;95%CI 22.33to21.42), particularlyfor liver(IBDAAPC8.48;95%CI4.11–13.1)and bile duct (IBD AAPC 7.22; 95% CI 3.74–10.8) cancers. Beyond 2010, the incidences (and respective mortality rates) of colorectal (1.60; 95% CI 1.46–1.75), small bowel (4.10; 95% CI 3.37–4.99), bile duct (2.33; 95% CI 1.96–2.77), and pancreatic (1.19; 95% CI 1.00–1.40) cancers were higher in people with IBD. DISCUSSION: Cancer incidence is declining for colorectal cancer and rising for other digestive cancers in people with IBD. Incidence and mortality remain higher in people with IBD than controls for colorectal, small bowel, bile duct, and pancreatic cancers. KEYWORDS: inflammatory bowel disease; Crohn’s disease; ulcerative colitis; cancer; epidemiology; incidence; mortality; trends; relative risk; rate ratio SUPPLEMENTARY MATERIAL accompanies this paper at [http://links.lww.com/AJG/D307](http://links.lww.com/AJG/D307) and [http://links.lww.com/AJG/D308](http://links.lww.com/AJG/D308) INFLAMMATORY BOWEL DISEASE Am J Gastroenterol 2024;119:2275–2287. [https://doi.org/10.14309/ajg.0000000000002900](https://doi.org/10.14309/ajg.0000000000002900) INTRODUCTION Inﬂammatory bowel diseases (IBDs), comprising Crohn’s disease (CD) and ulcerative colitis (UC), are highly morbid conditions aﬀecting the gastrointestinal(GI)tract and extraintestinal organs. IBD predisposes individuals to the development of intestinal cancers from chronic inﬂammatory damage (1–3) . While 1Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; 2The Ottawa Hospital, IBD Centre, Ottawa, Ontario, Canada; 3Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; 4ICES, Toronto, Canada; 5Division of Gastroenterology and Hepatology, University Health Network, University of Toronto, Toronto, Ontario, Canada; 6Department of Medicine, Queens University, Kingston, Ontario, Canada; 7Department of Medicine and Community Health Sciences, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; 8University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada; 9Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, Unive

FAQs

What question does the matched cohort study address?

It evaluates digestive system cancer incidence and cancer-related mortality in individuals with inflammatory bowel disease compared with matched controls over time.

How were people with IBD compared with controls?

Researchers used population-level administrative and cancer registry data from Ontario and matched people with IBD to controls 1:10 by sex and birth year.

What major trend differences were observed between IBD patients and controls?

Colorectal cancer incidence declined in both groups similarly, while small bowel and several extraintestinal digestive cancers rose faster in people with IBD.

Sep 21, 2026

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