Increased mortality in children with inflammatory bowel disease

October 18, 2018

Children who develop inflammatory bowel disease (ulcerative colitis or Crohn's disease) have an increased risk of death, both in childhood and later in life, a study from Karolinska Institutet in Sweden published in the journal Gastroenterology reports. It is therefore important that patients who are diagnosed as children are carefully monitored, argue the researchers behind the study.

The researchers identified patients with inflammatory bowel disease (IBD) such as ulcerative colitis and Crohn's disease between the years 1964 and 2014 via the Swedish patient register. Using these data, they compared mortality rates in about 9,400 children who developed IBD with those of other children.

Their results show that children who developed IBD before the age of 18 have a three to five-fold higher mortality rate than people without IBD, both during childhood and into adulthood. This translates to a 2.2-year reduction in life expectancy in individuals monitored up to the age of 65.

"It should be remembered that we're talking small differences in number of deaths," explains lead author Ola Olén, consultant and researcher at Karolinska Institutet's Department of Medicine in Solna. "Most young people with IBD do not die earlier than their peers, but a few individuals with a severe case of IBD and serious complications such as cancer greatly elevate the relative risk."

The most common cause of death was cancer, while fatalities due to IBD itself accounted for the largest relative increase in mortality.

"Individuals who are diagnosed in childhood need to be monitored carefully," says Dr Olén. "Those who might especially benefit from being closely monitored to avoid fatal intestinal cancer are children with ulcerative colitis, who also have the chronic liver disease primary sclerosing cholangitis."

IBD in adults has previously been linked to shortened life expectancy. IBD is often thought to have a more aggressive disease course in children than in adults and has been associated with several types of cancer. However, it has been unclear how life expectancy is affected by childhood-onset IBD and if the mortality rate has changed since the introduction of modern drugs.

"IBD therapy has improved greatly since the 1960s," says Dr Olén. "For one thing, we often now use new types of immunomodulating drugs. However, we couldn't see that mortality rates have gone down since their introduction."
-end-
The study was financed by the Swedish Society of Medicine, the Swedish Stomach and Bowel Association's Fund, the Jane and Dan Olsson Foundation, the Milk Drop Association, the Bengt Ihre scholarship for gastroenterological research, Karolinska Institutet's Foundations and Funds, ALF funding, the Swedish Cancer Society, the Swedish Research Council and the Swedish Foundation for Strategic Research.

Publication: "Increased Mortality of Patients with Childhood-onset Inflammatory Bowel Diseases, Compared With the General Population". Ola Olén, Johan Askling, Michael Sachs, Paolo Frumento, Martin Neovius, Karin Ekström Smedby, Anders Ekbom, Petter Malmborg and Jonas F Ludvigsson. Gastroenterology, online 17 October 2018, doi: 10.1053/j.gastro.2018.10.028.

Karolinska Institutet

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.