The prognosis of paediatric onset IBD remains uncertain. In this studi Tine Jess and colleague examined the overall and site-specific cancer risk among paediatric onset IBD patients when compared with non-IBD individuals from the general population. The risk was highest for liver, upper gastrointestinal, small bowel and colorectal cancer and was not influenced by medical treatment. Still, absolute numbers were low with only 1 additional cancer case per 1000 person-years of follow-up. This is important information to patients and clinicians.