- 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.
- 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.
- 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).
- 5-ASA treatment (OR, 0.57; P=.019); and
- biologics treatment (OR, 0.38; P<.001>
- 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).
- Observational design.
- Short follow-up.