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No increase in all-cause, cancer-related mortality among Crohn’s disease patients
Patients with Crohn’s disease are not at an increased risk for all-cause or cancer-related death compared with the general population in the 20 years after diagnosis, according to recent results.
In the Inflammatory Bowel South-Eastern Norway study, researchers prospectively followed 237 patients diagnosed with Crohn’s disease (CD) between Jan. 1, 1990 and Dec. 31, 1993 (median age at diagnosis, 28 years; 119 men, 118 women;) and 5,876 random, matched controls from the general population. Rates of all-cause and cause-specific mortality were determined and compared between groups after 20 years of follow-up.
Visits were conducted at 1, 5, 10 and 20 years after enrollment and included clinical examination, patient interview and laboratory tests, along with colonoscopy at the 5-, 10- and 20-year visits. CD diagnoses were systematically re-evaluated at 1, 5 and 10 years, with the diagnosis at 10 years considered final.
At 20 years, 13.9% of patients with CD and 12.7% of controls had died (P=.578). Patients with CD died due to gastrointestinal cancer in 9% of cases, compared with 8% of controls; other cancers in 21% of cases vs. 14%; and cardiovascular disease in 37% of cases vs. 33%.
No participants in either group had died due to small bowel malignancy. Three participants with CD died because of disease-related complications.
While CD patients had numerically higher overall mortality rates than controls, the difference was not significant (HR=1.35; 95% CI, 0.94-1.94). The prevalence of death from the four assessed causes also were similar between groups, though investigators noted a trend toward risk for death from non-GI cancer (HR=2.01; 95% CI, 0.95-4.49).
“The present follow-up study revealed no increase in overall mortality or cause-specific mortality among CD patients 20 years after diagnosis compared with the background population,” the researchers wrote. “Moreover, there were no statistically significant differences between the sexes with regard to overall or cause-specific mortality. This outcome might be explained by the inclusion of this nonselected population–based cohort in a generally well functioning health care system during the last two decades of follow-up.”