Hodgkin's disease risk is increased in patients with ulcerative colitis

Background & Aims: All patients diagnosed with ulcerative colitis (UC) or C rohn's disease (CD) residing in Florence, Italy, in 1978-1992 were identifi ed and included in a population-based study of cancer risk evaluation. Meth ods: A total of 920 patients were followed up (median, 11 years), and 64 ne wly diagnosed malignancies were identified by linkage to the local cancer r egistry. Expected cases were calculated on the basis of age- and sex-specif ic cancer incidence rates to estimate relative risks in comparison with the general population. Results: Overall, cancer incidence rates were not incr eased, A significant excess risk of Hodgkin's disease was observed among pa tients with UC (standardized incidence ratio, 9.3; 95% confidence interval [CI], 2.5-23.8). Respiratory tract cancers were significantly reduced to on e fourth of the expected rate in patients with UC, but tended to be increas ed among patients with CD, who had a 50% higher risk of cancer at all sites . Only a nonsignificant, modestly increased risk of colorectal cancer was o bserved. Conclusions: A strongly increased risk of Hodgkin's disease was ev ident in this first cancer follow-up of a representative series of patients with UC in a Mediterranean country. Two divergent risk patterns of respira tory tract cancers, possibly explained by differences in smoking habits, em erged in the 2 inflammatory bowel diseases.