Loes H C Nissen1,2, Lauranne A A P Derikx1, Anouk M E Jacobs1, Carla M van Herpen3, Wietske Kievit4, Rob Verhoeven5, Esther van den Broek6, Elise Bekers7, Tim van den Heuvel8, Marieke Pierik8, Janette Rahamat-Langendoen9, Robert P Takes10, Willem J G Melchers9, Iris D Nagtegaal7, Frank Hoentjen1. 1. Inflammatory Bowel Disease Centre, Department of Gastroenterology and Hepatology. 2. Department of Gastroenterology and Hepatology, Jeroen Bosch Ziekenhuis, Den Bosch, the Netherlands. 3. Department of Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands. 4. Department for Health Evidence, Radboud University Medical Centre, Nijmegen, the Netherlands. 5. Netherlands Cancer Registry/Netherlands Comprehensive Cancer Organization. 6. Stichting PALGA, The Netherlands. 7. Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands. 8. Department of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, the Netherlands. 9. Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, the Netherlands. 10. Department of Otorhinolaryngology, Radboud University Medical Centre, Nijmegen, the Netherlands.
Abstract
Background: Immunosuppressed inflammatory bowel disease (IBD) patients are at increased risk to develop extra-intestinal malignancies. Immunosuppressed transplant patients show increased incidence of head and neck cancer with impaired survival. This study aims to identify risk factors for oral cavity (OCC) and pharyngeal carcinoma (PC) development in IBD, to compare clinical characteristics in IBD with the general population, and to assess the influence of immunosuppressive medication on survival. Methods: We retrospectively searched the Dutch Pathology Database to identify all IBD patients with OCC and PC between 1993 and 2011. Two case-control studies were performed: We compared cases with the general IBD population to identify risk factors, and we compared cases with non-IBD cancer patients for outcome analyses. Results: We included 66 IBD patients and 2141 controls with OCC, 31 IBD patients and 1552 controls with PC, and 1800 IBD controls. Age at IBD diagnosis was a risk factor for OCC development, Crohn's disease (CD; odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02-1.07), and ulcerative colitis (UC; OR, 1.03; 95% CI, 1.01-1.06). For PC, this applied to UC (OR, 1.05; 95% CI, 1.01-1.06). IBD OCC cases showed impaired survival (P = 0.018); in PC, survival was similar. There was no effect of immunosuppression on survival. Human papillomavirus (HPV) testing of IBD cases revealed 52.2% (12/23) HPV-positive oropharyngeal carcinomas (OPCs). Conclusion: This study shows that IBD is associated with impaired OCC survival. Higher age at IBD diagnosis is a risk factor for OCC development. We found no influence of immunosuppression on survival; 52.2% of OPC in IBD contained HPV.
Background: Immunosuppressed inflammatory bowel disease (IBD) patients are at increased risk to develop extra-intestinal malignancies. Immunosuppressed transplant patients show increased incidence of head and neck cancer with impaired survival. This study aims to identify risk factors for oral cavity (OCC) and pharyngeal carcinoma (PC) development in IBD, to compare clinical characteristics in IBD with the general population, and to assess the influence of immunosuppressive medication on survival. Methods: We retrospectively searched the Dutch Pathology Database to identify all IBD patients with OCC and PC between 1993 and 2011. Two case-control studies were performed: We compared cases with the general IBD population to identify risk factors, and we compared cases with non-IBD cancerpatients for outcome analyses. Results: We included 66 IBD patients and 2141 controls with OCC, 31 IBD patients and 1552 controls with PC, and 1800 IBD controls. Age at IBD diagnosis was a risk factor for OCC development, Crohn's disease (CD; odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02-1.07), and ulcerative colitis (UC; OR, 1.03; 95% CI, 1.01-1.06). For PC, this applied to UC (OR, 1.05; 95% CI, 1.01-1.06). IBD OCC cases showed impaired survival (P = 0.018); in PC, survival was similar. There was no effect of immunosuppression on survival. Human papillomavirus (HPV) testing of IBD cases revealed 52.2% (12/23) HPV-positive oropharyngeal carcinomas (OPCs). Conclusion: This study shows that IBD is associated with impaired OCC survival. Higher age at IBD diagnosis is a risk factor for OCC development. We found no influence of immunosuppression on survival; 52.2% of OPC in IBD contained HPV.
Authors: Steffi E M van de Ven; Lauranne A A P Derikx; Iris D Nagtegaal; Carla M van Herpen; Robert P Takes; Willem J G Melchers; Marieke Pierik; Tim van den Heuvel; Rob H A Verhoeven; Frank Hoentjen; L H C Nissen Journal: Inflamm Bowel Dis Date: 2020-06-18 Impact factor: 5.325