S45 Cancers Associated With Inflammatory Bowel Disease: A Population-Based Case-Control Study
Bibliographic record
Abstract
Background: Individuals with inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are known to have a higher risk of digestive tract cancers as compared to the general population. As the IBD population has gotten older over time, age-related cancers may be more commonly diagnosed. We conducted a population-based study to assess whether incident cancers were being diagnosed more commonly overtime and whether those with IBD were more likely to be diagnosed with cancer. Methods: A population-based surveillance case-control study was conducted in in Alberta, Canada from April 1, 2002 to March 31, 2018. A validated coding algorithm identified all cases of IBD stratified by type of IBD (CD, UC). Each case was age and sex matched to 10 non-IBD cases from the general population, and then linked to the Alberta provincial cancer registry to extract pathology-confirmed incident cancer. Cancer diagnoses were classified: colorectal, small bowel, pancreatic, biliary and liver, breast, cervical, endometrial, thyroid, hematological, lung, neurological, melanoma, non-melanoma skin cancer, prostate, renal, and bladder. Odds ratios (OR), with 95% confidence intervals (CI), compared IBD cases to matched controls using conditional logistic regression. The annual incidence of cancer diagnosis among the at-risk prevalent IBD population was determined with the average annual percentage change (AAPC) calculated using log binomial regression. Results: Overall, 3,695 incident cancers were diagnosed among 35,763 individuals with IBD as compared to 31,365 cancers among 362,248 controls (IBD: OR = 1.22; 95% CI: 1.18, 1.27; CD: OR = 1.42, 95% CI: 1.34, 1.49; UC: OR = 1.13 95% CI: 1.06, 1.20). Annual incident cancers in those with IBD steadily increased by 3.4% per year (AAPC = 3.44%; 95% CI: 2.71%, 4.18%). A higher odds of cancer was observed across digestive tract cancers for those with IBD: biliary and liver (IBD: OR = 7.76; 95% CI: 5.89, 10.22); colorectal cancer (IBD: OR = 1.88; 95% CI: 1.67, 2.15); small bowel (CD: OR = 10.81; 95% CI: 6.89, 16.95; UC: OR = 1.74; 0.73, 4.16); and pancreas (IBD: OR = 8.01; 95% CI: 5.72, 11.20). Outside of the digestive tract the following cancers were more common in those in IBD: hematological (IBD: OR = 1.47, 95% CI: 1.29, 1.67); lung (IBD: OR = 4.16; 95% CI: 3.59, 4.81); neurological (IBD: OR = 4.73; 95% CI: 3.12, 7.18; and renal (IBD: OR = 2.18; 95% CI: 1.77, 2.68). Non-melanoma skin cancers were associated with IBD (OR = 1.11; 95% CI: 1.05, 1.18), but not melanoma (OR = 0.98; 95% CI: 0.82, 1.18). Other solid-organ cancers were not associated or occurred less commonly in those with IBD: prostate (OR = 0.68; 95% CI: 0.60, 0.77); bladder (OR = 0.73; 95% CI: 0.57, 0.92), cervix (OR = 0.83; 95% CI: 0.73, 0.93), endometrium (OR = 0.50; 95% CI: 0.36, 0.70), and thyroid (OR = 0.84; 95% CI: 0.65, 1.10). Conclusion(s): Over time, persons with IBD are being more commonly diagnosed with cancer. Individuals with IBD are more likely to be diagnosed with cancer as compared to the general population with cancers of the digestive tract driving this association. Healthcare providers should be aware of higher occurrence of hematological, neurological, lung and renal cancers in those with IBD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".