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Journal Article

Citation

Banerjee T, Gearry R. Aliment. Pharmacol. Ther. 2019; 50(1): 105-106.

Affiliation

Department of Gastroenterology, Christchurch Hospital, Christchurch, New Zealand.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1111/apt.15299

PMID

31184390

Abstract

Mortality from inflammatory bowel disease (IBD) is rare and even rarer in paediatric patients. Usually when we consider causes of death in patients with IBD, cancer, venous thromboembolism, sepsis and nutrition are at the front of mind. However, the population‐based retrospective study by Malham et al1 has made us think more laterally about mortality in young people with IBD, and challenges us to be more vigilant for mental health issues.

In their study, Malham et al identified all Danish and Finnish patients diagnosed with paediatric inflammatory bowel disease (pIBD) over a 23‐year period. They cross‐linked each patient to the national cancer registries and the national cause of death registries to estimate cancer and mortality risks for their pIBD cohort. They found an increased risk of cancer and mortality in their pIBD population; a 2.5 risk of cancer and a threefold increase in the standardised mortality ratio, higher than that reported in the adult population. The median time from IBD diagnosis to cancer was 11.5 years with a median age of cancer diagnosis of 25 years. The most common cancer was colorectal adenocarcinoma. The leading causes of mortality were found to be cancer, suicide and infections with a median age of mortality of 22 years.

An unexpected and sobering finding was the fourfold increase in death rate due to suicide for pIBD patients compared to the general population. Although the registry data were not verified, this finding is clearly alarming. It is well recognised that all IBD populations have both poorer mental and physical quality of life (QoL) than controls and have an increased risk of depressive disorders ...


Language: en

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