成人发病的免疫介导的炎症性疾病 (IMID) 会增加多种癌症的风险。然而，有关儿科发病 IMID (pIMID) 的数据仍然很少。我们评估了 pIMID 的长期癌症风险以及药物治疗与特定癌症之间的关联。我们使用丹麦全国健康登记册来识别 1980 年 1 月 1 日至 2018 年 12 月 31 日诊断的 pIMID 患者。患者与 10 名参考个体进行匹配基于年龄、性别和居住地。主要暴露为pIMID，包括自身免疫性肝炎、原发性硬化性胆管炎、克罗恩病、溃疡性结肠炎、幼年特发性关节炎、系统性红斑狼疮、血管炎和结缔组织病。二次暴露是免疫调节剂和肿瘤坏死因子-α拮抗剂（抗TNFα）。主要结果是癌症。估计值以根据诊断时家庭收入 (AHR) 调整的风险比表示。我们纳入了 12,664 名 pIMID 患者和 109,274 名参考个体。患者的中位随访时间为 10.6 年（四分位距：5.4-17.7）年，参考个体的中位随访时间为 10.2 年（四分位距：5.2-17.3）年。与参考个体相比，pIMID 患者的癌症风险高出两倍（AHR 2.2 [95% 置信区间 (CI)：1.8-2.6]）。硫嘌呤治疗与淋巴瘤 (AHR 6.1 [95%CI: 2.2-16.8]) 和皮肤癌 (AHR 6.1 [95%CI: 2.4-15.4]) 的风险较高相关。抗 TNFα 治疗与淋巴瘤风险较高相关（AHR 4.9 [95%CI：1.1-22.6]）。我们发现 pIMID 患者成年后患癌症的风险增加。此外，硫嘌呤和抗 TNFα 与淋巴瘤和皮肤癌风险增加有关。这凸显了个体化免疫治疗和癌症监测的重要性。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Adult-onset immune-mediated inflammatory disease (IMID) increases the risk of several cancers. However, data on pediatric-onset IMID (pIMID) remains scarce. We estimated the long-term cancer risk in pIMID and the association between medical treatment and specific cancers.We used the nationwide Danish health registers to identify pIMID patients diagnosed from Jan 1, 1980 to Dec 31, 2018. Patients were matched with ten reference individuals based on age, sex, and residence. The primary exposure was pIMID, including autoimmune hepatitis, primary sclerosing cholangitis, Crohn's disease, ulcerative colitis, juvenile idiopathic arthritis, systemic lupus erythematosus, vasculitis, and connective tissue disease. Secondary exposures were immunomodulators and tumor necrosis factor-α antagonists (anti-TNFα). The primary outcome was cancer. Estimates are presented as hazard ratios adjusted for family income at diagnosis (AHR).We included 12,664 pIMID patients and 109,274 reference individuals. Median follow-up time was 10.6 (interquartile range: 5.4-17.7) years for patients and 10.2 (interquartile range: 5.2-17.3) years for reference individuals. Patients with pIMID had a twofold higher cancer risk (AHR 2.2 [95 % confidence interval (CI): 1.8-2.6]) compared with reference individuals. Thiopurine treatment was associated with a higher risk of lymphoma (AHR 6.1 [95%CI: 2.2-16.8]) and skin cancer (AHR 6.1 [95%CI: 2.4-15.4]). Anti-TNFα treatment was associated with a higher risk of lymphoma (AHR 4.9 [95%CI: 1.1-22.6]).We found an increased cancer risk in patients with pIMID followed into adulthood. Additionally, thiopurines and anti-TNFα were associated with increased lymphoma and skin cancer risks. This highlights the importance of individualized immunotherapy and cancer surveillance.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.