Epidemiologic Associations Between Inflammatory Bowel Disease and Hodgkin Lymphoma or Multiple Sclerosis

Abstract

Background and AimsEpidemiologic evidence suggests that Hodgkin lymphoma (HL) and multiple sclerosis (MS) share a common set of risk factors with Crohn’s disease (CD) and ulcerative colitis (UC). It was hypothesized that such shared risk factors would lead to similar geographic distributions of these 4 diagnoses and to their concurrence in identical patients. MethodsAll subjects with HL, MS, CD, or UC were identified in the complete Inpatient Standard Analytic File of the Centers for Medicare and Medicaid Services (CMS) from 2018. In a cross-sectional study, we evaluated whether the frequencies of HL, MS, CD, and UC occurrence among different US states were statistically correlated with each other. In a case-control study, the observed concurrences of each 2 of 4 diagnoses were compared with their expected frequencies in the overall Medicare population by calculating odds ratios (OR) with their 95% confidence intervals (CI). ResultsThe total CMS population comprised 6,462,321 unique patients, of whom 8,027 presented with HL, 42,934 with MS, 40,623 with CD, and 32,521 with UC. Statistically significant positive correlations (r) with p<0.001 were found between HL and MS (r=0.50), HL and CD (0.46), HL and UC (0.68), MS and CD (0.66), MS and UC (0.72), CD and UC (0.68). Any inflammatory bowel disease (IBD) was significantly associated with a diagnosis of concurrent HL (OR: 1.22, 95%CI: 1.01-1.48) or MS (1.35, 1.25-1.46). ConclusionsThe epidemiologic associations of IBD with HL or MS may reflect on a common pathway in the etiology or pathogenesis of these diseases.