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Crohn's Disease Is Associated with the Risk for Thyroid Cancer

Wadhwa, Vaibhav MD; Lopez, Rocio MS, MPH; Shen, Bo MD

doi: 10.1097/MIB.0000000000000963
Original Clinical Articles

Background: It is known that inflammatory bowel disease (IBD) is associated with a high risk for some of extraintestinal cancers. The aim of this study was to identify whether IBD is associated with thyroid cancer using a large national database.

Methods: We performed a case–control study using the 2012 National Inpatient Sample (NIS) database. The study group included all patients with Crohn's disease (CD) (ICD-9 Code: 555) and ulcerative colitis (UC) (ICD-9 Code: 556), and the control group included all patients with diverticulitis (ICD-9 Code: 562.11, 562.13). Both univariable and multivariable analyses were performed to assess the risk factors associated with thyroid cancer.

Results: We analyzed more than 28 million hospitalizations in 2012, with 289,935 being IBD-related admissions and 315,145 being diverticulitis-related admissions. Subjects who had IBD were found to be significantly more likely to have thyroid cancer than those with diverticulitis (odds ratio = 1.97 [1.5–2.6], P = 0.033). There was no difference between men and women in the prevalence of thyroid cancer in IBD (P = 0.6). There was no difference between CD and UC (P = 0.14) and between UC and diverticulitis (P = 0.93). In multivariate analysis, CD was found to be associated with thyroid cancer (odds ratio = 2.3 [1.06–5.1], P = 0.034). Age was shown to be a protective factor in the presence of thyroid cancer (P < 0.005), and a higher Charlson comorbidity index was associated with the presence of thyroid cancer (odds ratio, 1.5 [1.3–1.7]; P < 0.001).

Conclusions: Our study showed that CD, not UC, is associated with a higher risk for thyroid cancer. It is recommended that patients with CD may need a close monitoring of thyroid diseases.

Supplemental Digital Content is Available in the Text.Article first published online 8 November 2016.

*Department of Internal Medicine, Fairview Hospital, the Cleveland Clinic Foundation, Cleveland, Ohio; and

Center for Inflammatory Bowel Diseases, Digestive Disease and Surgery Institute, the Cleveland Clinic Foundation, Cleveland, Ohio.

Address correspondence to: Bo Shen, MD, Center for Inflammatory Bowel Diseases, Digestive Disease and Surgery Institute-A31, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195 (e-mail:

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

B. Shen is supported by the Ed and Joey Story Endowed Chair.

The authors have no conflict of interest to disclose.

Received May 16, 2016

Accepted September 16, 2016

© Crohn's & Colitis Foundation of America, Inc.
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