Alicia Algaba1, Iván Guerra2, Ignacio Marín-Jiménez3, Elvira Quintanilla4, Pilar López-Serrano5, María Concepción García-Sánchez6, Begoña Casis7, Carlos Taxonera8, Ignacio Moral9, María Chaparro10, Daniel Martín-Rodríguez11, María Dolores Martín-Arranz12, Noemí Manceñido13, Luis Menchén3, Antonio López-Sanromán6, Ángel Castaño14, Fernando Bermejo2. 1. Departments of Gastroenterology: Hospital Universitario de Fuenlabrada alicia_algaba@hotmail.com. 2. Departments of Gastroenterology: Hospital Universitario de Fuenlabrada. 3. Hospital Universitario Gregorio Marañón. 4. Hospital Universitario Severo Ochoa. 5. Hospital Universitario Fundación Alcorcón. 6. Hospital Universitario Ramón y Cajal. 7. Hospital Universitario 12 de Octubre. 8. Hospital Clínico San Carlos, IdISSC. 9. Hospital Príncipe de Asturias. 10. Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa [IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD]. 11. Hospital Universitario Infanta Cristina. 12. Hospital Universitario La Paz. 13. Hospital Universitario Infanta Sofía. 14. Department of Pathology. Hospital Universitario de Fuenlabrada; Madrid, Spain.
Abstract
BACKGROUND AND AIMS: Patients with inflammatory bowel disease [IBD] are at increased risk for developing some types of neoplasia. Our aims were to determin the risk for cancer in patients with IBD and to describe the relationship with immunosuppressive therapies and clinical management after tumor diagnosis. METHODS: Retrospective, multicenter, observational, 5-year follow-up, cohort study. Relative risk [RR] of cancer in the IBD cohort and the background population, therapeutic strategies, and cancer evolution were analyzed. RESULTS: A total of 145 cancers were diagnosed in 133 of 9100 patients with IBD (global cumulative incidence 1.6% vs 2.4% in local population; RR = 0.67; 95% confidence interval [CI]: 0.57-0.78). Patients with IBD had a significantly increased RR of non-melanoma skin cancer [RR = 3.85; 2.53-5.80] and small bowel cancer [RR = 3.70; 1.23-11.13]. After cancer diagnosis, IBD treatment was maintained in 13 of 27 [48.1%] patients on thiopurines, in 2 of 3 on methotrexate [66.6%], none on anti-TNF-α monotherapy [n = 6] and 4 of 12 [33.3%] patients on combined therapy. Rate of death and cancer remission during follow-up did not differ [p > 0.05] between patients who maintained the treatment compared with patients who withdrew [5% vs 8% and 95% vs 74%, respectively]. An association between thiopurines [p = 0.20] or anti-TNF-α drugs [p = 0.77] and cancer was not found. CONCLUSIONS: Patients with IBD have an increased risk for non-melanoma skin cancer and small bowel cancer. Immunosuppresive therapy is not related to a higher overall risk for cancer or worse tumor evolution in patients who maintain these drugs after cancer diagnosis.
BACKGROUND AND AIMS: Patients with inflammatory bowel disease [IBD] are at increased risk for developing some types of neoplasia. Our aims were to determin the risk for cancer in patients with IBD and to describe the relationship with immunosuppressive therapies and clinical management after tumor diagnosis. METHODS: Retrospective, multicenter, observational, 5-year follow-up, cohort study. Relative risk [RR] of cancer in the IBD cohort and the background population, therapeutic strategies, and cancer evolution were analyzed. RESULTS: A total of 145 cancers were diagnosed in 133 of 9100 patients with IBD (global cumulative incidence 1.6% vs 2.4% in local population; RR = 0.67; 95% confidence interval [CI]: 0.57-0.78). Patients with IBD had a significantly increased RR of non-melanoma skin cancer [RR = 3.85; 2.53-5.80] and small bowel cancer [RR = 3.70; 1.23-11.13]. After cancer diagnosis, IBD treatment was maintained in 13 of 27 [48.1%] patients on thiopurines, in 2 of 3 on methotrexate [66.6%], none on anti-TNF-α monotherapy [n = 6] and 4 of 12 [33.3%] patients on combined therapy. Rate of death and cancer remission during follow-up did not differ [p > 0.05] between patients who maintained the treatment compared with patients who withdrew [5% vs 8% and 95% vs 74%, respectively]. An association between thiopurines [p = 0.20] or anti-TNF-α drugs [p = 0.77] and cancer was not found. CONCLUSIONS:Patients with IBD have an increased risk for non-melanoma skin cancer and small bowel cancer. Immunosuppresive therapy is not related to a higher overall risk for cancer or worse tumor evolution in patients who maintain these drugs after cancer diagnosis.
Authors: Renata D Peixoto; Artur R Ferreira; James M Cleary; João P Fogacci; João P Vasconcelos; Alexandre A Jácome Journal: J Gastrointest Cancer Date: 2022-03-14
Authors: Edward Shelton; David Laharie; Frank I Scott; Ronac Mamtani; James D Lewis; Jean-Frederic Colombel; Ashwin N Ananthakrishnan Journal: Gastroenterology Date: 2016-04-01 Impact factor: 22.682