Malignancy in Crohn's disease

SUMMARY Cancer morbidity has been evaluated in a series of 513 patients with Crohn's disease under long-term review between 1944-76. In comparison with morbidity rates for cancer in the West Midlands Region (the geographical area from which these patients were drawn) the 31 tumours that occurred represented a relative risk of 1.7 (p < 001) of cancer at all sites. For tumours at sites within the digestive system the relative risk was 3.3 (p <000 1). A significant excess of tumours was found in both the upper (P < 0.01) and lower (P < 0.001) gastrointestinal tract. There was no excess of tumours at any site outside the digestive system. The first reported case of cancer of the large intestine occurring in Crohn's disease was described by Warren and Sommers, ' while Ginzburg and his colleagues2 first drew attention to carcinoma of the small intestine complicating Crohn's disease. Individual reports of cancer in Crohn's disease have been summarised.3 Other examples of cancer and Crohn's disease have been described else