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Pyogenic liver abscess associated with heightened risk for GI cancer
Patients with pyogenic liver abscess are more than four times more likely to have gastrointestinal cancer, according to study results.
“The cumulative incidence of GI cancers, with the exception of stomach cancer, is significantly higher in patients with PLA [pyogenic liver abscess] compared with controls, and the highest incidence is observed for colorectal cancer,” the researchers wrote.
The population-based, retrospective, cohort study analyzed data from 14,690 patients in Taiwan diagnosed with PLA between 2000 and 2007. A control cohort of 58,760 patients without PLA also was selected from the same database. The cohorts were followed through 2009.
The study found 784 cases of GI cancer among control group patients, followed for 312,909 patient-years for an incidence rate of 2.51 per 1,000 patient-years. Among PLA patients, 760 cases were found across 70,069 patient-years, yielding an incidence rate of 10.8 per 1,000 patient-years. When factoring in age and sex, the adjusted HR was 4.58 (95% CI, 4.14-5.06).
The HR among women was greater than it was among men. Women in the control group had a 2.21 incidence rate per 1,000 person-years compared with a rate of 12.1 for women in the PLA group (aHR=5.67; 95% CI, 4.81-6.7). Men in the control group had a 2.68 incidence rate, while men in the PLA cohort had a 10.2 incidence rate (aHR=4.04; 95% CI, 3.56-4.59).
Cancer of the small intestine demonstrated the highest aHR (12.66; 95% CI, 5.79-27.69), followed by cancer of the biliary tract (aHR=9.56; 95% CI, 6.68-13.69) and colorectal cancer (aHR=5.50; 95% CI, 4.83-6.25). Colorectal cancer had the highest incidence rate (7.28 among PLA patients vs. 1.55 among controls), while cancer of the small intestine had the lowest rate (0.36 for PLA patients vs. 0.03 for controls).
“Further evaluation of these patients is warranted to achieve earlier diagnosis of these malignancies,” the researchers concluded. “Future studies should determine if such evaluations reduce morbidity and mortality for these patients.”
Disclosure: The researchers report no relevant financial disclosures.