IBD tied to risks for lymphoma, biliary cancer — but not CRC

  • Am J Gastroenterol

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Patients with inflammatory bowel disease (IBD) are at risk for lymphoma and biliary cancer, but not colorectal cancer (CRC) or cancer overall.
  • Protective factors included 5-aminosalicylates (5-ASA) and biologics.

Why this matters

  • Study represents one of the largest IBD cohorts to provide data on malignancy, as well as risk and protective factors.

Study design

  • The Swiss IBD Cohort Study (n=3119) had a cross-sectional case-control component of patients with IBD with and without malignancies, and a longitudinal component of patients with newly diagnosed malignancy.
  • Funding: Swiss National Science Foundation.

Key results

  • Malignancy prevalence was 3.9%.
  • In case-control component, predictors of malignancy:
    • older age at diagnosis (OR, 1.04 per year; P<.001>
    • intestinal surgery (OR, 3.34; P<.001 and>
    • steroid treatment (OR, 2.10; P=.001).
  • In case-control component, protective factors for malignancy:
    • 5-ASA treatment (OR, 0.57; P=.019); and
    • biologics treatment (OR, 0.38; P<.001>
  • In longitudinal component (median follow-up of 4.9 years):
    • no increased risk of overall malignancy (standardized incidence ratio [SIR], 0.93; 95% CI, 0.72-1.18) or CRC (SIR, 1.55; 95% CI, 0.71-2.95);
    • increased risk of lymphoma (SIR, 2.98; 95% CI, 1.36-5.66), biliary cancer (SIR, 6.3; 95% CI, 1.27-18.41);
    • Recent use of immunomodulators was a predictor of malignancy (HR, 2.31; P=.006).

Limitations

  • Observational design.
  • Short follow-up.

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