BACKGROUND The global incidence of cirrhosis and luminal gastrointestinal cancers are increasing.It is unknown if cirrhosis itself is a predisposing factor for luminal gastrointestinal cancer.Such an association would...BACKGROUND The global incidence of cirrhosis and luminal gastrointestinal cancers are increasing.It is unknown if cirrhosis itself is a predisposing factor for luminal gastrointestinal cancer.Such an association would have significant clinical implications,particularly for cancer screening prior to liver transplantation.AIM To investigate the incidence of luminal gastrointestinal cancers in patients with underlying cirrhosis.METHODS An electronic search was conducted to study the incidence of luminal gastrointestinal cancers in patients with cirrhosis.Study-specific standardized incidence ratios(SIR)along with corresponding 95%CI for both overall cancer incidence and luminal cancer incidence were analyzed using a random-effects model.Subgroup analysis was performed based on cirrhosis etiology and location of luminal malignancy.RESULTS We identified 5054 articles;4 studies were selected for data extraction.The overall incidence of all cancers was significantly higher in patients with cirrhosis,with an SIR of 2.79(95%CI:2.18–3.57).When stratified by cirrhosis etiology,the incidence of luminal cancers remained significantly elevated for alcohol(SIR=3.13,95%CI:2.24–4.39),Primary Biliary Cholangitis(SIR=1.40,95%CI:1.10–1.79),and unspecified cirrhosis(SIR=3.52,95%CI:1.87–6.65).CONCLUSION The incidence of luminal gastrointestinal cancer is increased amongst patients with cirrhosis.Oral cavity,pharyngeal and esophageal cancer had increased incidence across all cirrhosis etiologies compared to gastric and colorectal cancer.Therefore,increased screening of luminal cancers,and in particular these upper luminal tract subtypes,should be considered in this population.展开更多
文摘BACKGROUND The global incidence of cirrhosis and luminal gastrointestinal cancers are increasing.It is unknown if cirrhosis itself is a predisposing factor for luminal gastrointestinal cancer.Such an association would have significant clinical implications,particularly for cancer screening prior to liver transplantation.AIM To investigate the incidence of luminal gastrointestinal cancers in patients with underlying cirrhosis.METHODS An electronic search was conducted to study the incidence of luminal gastrointestinal cancers in patients with cirrhosis.Study-specific standardized incidence ratios(SIR)along with corresponding 95%CI for both overall cancer incidence and luminal cancer incidence were analyzed using a random-effects model.Subgroup analysis was performed based on cirrhosis etiology and location of luminal malignancy.RESULTS We identified 5054 articles;4 studies were selected for data extraction.The overall incidence of all cancers was significantly higher in patients with cirrhosis,with an SIR of 2.79(95%CI:2.18–3.57).When stratified by cirrhosis etiology,the incidence of luminal cancers remained significantly elevated for alcohol(SIR=3.13,95%CI:2.24–4.39),Primary Biliary Cholangitis(SIR=1.40,95%CI:1.10–1.79),and unspecified cirrhosis(SIR=3.52,95%CI:1.87–6.65).CONCLUSION The incidence of luminal gastrointestinal cancer is increased amongst patients with cirrhosis.Oral cavity,pharyngeal and esophageal cancer had increased incidence across all cirrhosis etiologies compared to gastric and colorectal cancer.Therefore,increased screening of luminal cancers,and in particular these upper luminal tract subtypes,should be considered in this population.
