TORNA ALL’ELENCO

Inflammatory bowel disease phenotype as risk factor for cancer in a prospective multicenter Nested casecontrol IG-IBD study in Digestive and Liver Disease

2016
AO Ordine Mauriziano

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (27)Vedi tutti...

Biancone L
Praxis Dr Grün, Bad Windsheim, Germany
Armuzzi A
Praxis Dr Grün, Bad Windsheim, Germany
Scribano ML
Praxis Dr Grün, Bad Windsheim, Germany

et alii...

Abstract

Background and aim: The risk of cancer using immunomodulators for Inflammatory Bowel Disease (IBD) is debated. In a 3-year prospective, multicenter, nested case-control study, we aimed to characterize incident cases of cancer in IBD. The role of clinical characteristics of IBD vs immunomodulators use in determining the cancer risk was also investigated. Material and methods: From January 2012 to December 2014, all incident cancers in IBD patients referring to 16 IBD Units were recorded. Each patient with cancer (IBD-K) was matched with 2 IBD patients without cancer (IBD-C) for: IBD type, gender, age (±5 years). Data were expressed as median (range), Wilcoxon test, multivariate logistic regression analysis (OR [95%CI]), Chi-Square test. Results: Overall, 44,619 IBD patients were considered: 21,953 CD, 22,666 UC. Cancer occurred in 174 IBD patients: 99 CD (CD-K), 75 UC (UC-K). Cancer incidence in IBD was 3.9/1000, being higher in CD (4.5/1000 [99/ 21,953]) than in UC (3.3/1000 [75/22,666]; p=0.042). Cancers involved: digestive system (36.8%: CRC 67.2%; ileum 12.5%; others 20.3%), skin (13.2%), urinary tract (12.1%), lung (8.6%), breast (8%), genital (6.9%), thyroid (4.6%), lymphoma (6CD; 3.5%), others (6.3%). The percentage of patients with penetrating CD was higher in CD-K vs CD-C (26%; 26/99 vs 15%; 30/198; p=0.02) and with extensive UC in UC-K vs UC-C (55%; 41/75 vs 34%; 51/159; p=0.003). In CD, penetrating behavior and combined thiopurines (IS) and TNF? antagonists were risk factors for cancer overall (OR 2.33 [1.01-5.47]; 1.97 [1.1-3.5]), for extracolonic cancers (OR 3.9 [1.56- 10.1]; 2.15 [1.17-4.1]), but not for CRC. Risk factors in UC included pancolitis and surgery for cancer overall (OR 2.52 [1.26-5.1]; 5.09 [1.73-17.1]); surgery for CRC (OR 3.6 [1.0-12]); extensive vs distal, subtotal vs distal UC for extracolonic cancers (OR 2.55 [1.15-5.9]; 2.6 [1.04-6.6]). Conclusions: In a multicenter study, CD phenotype, penetrating CD, extensive UC represente

Keywords

immunoglobulin; immunomodulating agent; gastrointestinal disease; phenotype; neoplasm; risk factor; inflammatory bowel disease; organization; human; patient; surgery; multivariate logistic regression analysis; case control study; cancer risk; breast; rank sum test; urinary tract; lymphoma; pancolitis; ileum; cancer incidence; gender; digestive system; chi square test; skin; lung; thyroid gland; multicenter study; risk;