Two divergent patterns of mortality for smoking-related diseases in ulcerative colitis and Crohn’s disease patients have been suggested in a previous study in Florence, Italy.
Long-term follow-up was completed to re-evaluate mortality in this cohort.
In this study, doctors followed 920 inflammatory bowel disease patients until December 2001 or death (7 patients were lost to follow up).
A total of 14,040 person years were available for analysis
The team found that there were 118 deaths (81/689 in ulcerative colitis and 37/231 in Crohn’s disease).
The doctors calculated expected deaths using age, sex, and calendar specific national and local mortality rates
They found that mortality was strongly increased for gastrointestinal diseases, all cancers, and lung cancer in Crohn's disease patients. This led to a significant 50% excess total mortality.
However, ulcerative colitis patients showed a significantly reduced total mortality due to lower cardiovascular and lung cancer mortality.
No significant excess for colorectal cancer mortality was evident in this extended follow up.
Dr Masala and colleagues concluded, "These clearly divergent patterns of mortality correlate with documented differences in smoking habits between Crohn’s disease and ulcerative colitis patients".
"Family doctors and gastroenterologists should consider stopping cigarette smoking a specific priority for Crohn’s disease patients; the latter should be offered free participation in structured programs for smoking cessation, with the aim of reducing smoking related excess mortality".
"Overall, no evidence of an increased mortality for large bowel cancer emerged in this series".