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Risk For Digestive Tract Cancers Increases In Adult Cystic Fibrosis Patients

Adult patients with cystic fibrosis face an increased risk for digestive tract cancers, especially of the small bowel, colon and biliary tract.

Researchers from Italy and the United States say that the increased risk is more pronounced in patients with cystic fibrosis who have had organ transplantation.

The investigators, from the European Institute of Oncology in Milan, and the New York Medical College in Valhalla, New York, followed 28,858 patients whose data were reported to the Cystic Fibrosis Foundation patient registry from 1990 through 1999. The number of cancers seen in non-transplanted cystic fibrosis patients was compared to the number expected, based on population-based cancer incidence data.

There were 202,999 person-years of observation in non-transplanted patients. Seventy five cancers were found, and 69.7 were expected from general cancer incidence data. The standardised incidence ratio (SIR) was 1.1.

There were 23 digestive tract tumours, with 4.5 expected, giving an SIR of 5.1. There were more cancers of the small bowel, colon and biliary tract than expected. This was not true of the stomach or rectum. A deficit of non-digestive tract tumours was not statistically significant.

In 1,063 transplanted patients, there were 2,725 person-years of observation. In these patients, 13 cancers were observed and 2.05 were expected, for an SIR of 6.3. More digestive tract tumours (4) than expected (0.19) were observed, for an SIR of 21.2. More lymphomas (7) than expected (0.16) were also seen, for an SIR of 44.0.
Journal of the National Cancer Institute, 2003;95:5:381-387. "Cancer risk in nontransplanted and transplanted cystic fibrosis patients: a 10-year study"

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