title: Extra-intestinal malignancies in inflammatory bowel disease: results of the 3rd ECCO Pathogenesis Scientific Workshop (III).
abstract: The incidence of lymphoproliferative disorders (LD) is increasing in developed countries. Patients with inflammatory bowel disease (IBD) exposed to thiopurines are at additional risk of three specific forms of LD: Epstein-Barr-Virus-related post-transplant like LD, hepato-splenic T-cell lymphoma and post-mononucleosis lymphoproliferation. The risk of the two latter forms of LD can be reduced when considering specific immunosuppressive strategies in young males. It is still unclear whether the risk of uterine cervix abnormalities is increased in IBD women, irrespective of the use of immunosuppressants. Given the excess risk demonstrated in various other contexts of immunosuppression, it is currently recommended that all women with IBD, particularly those receiving immunosuppressants, strictly adhere to a screening program of cervical surveillance and undergo vaccination against HPV, when appropriate. Patients with IBD receiving immunosuppressants are at increased risk of skin cancers. The risk of non-melanoma skin cancer is notably increased in patients receiving thiopurines. Recent data suggest that the risk of melanoma is mildly increased in patients exposed to anti-TNF therapy. All IBD patients should adhere to a program of sun protection and dermatological surveillance, whose details should take into account the other non-IBD-related risk factors.
authors.affiliation: Gastroenterology Department, Centro Hospitalar S. João, Institute of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal; Institute for Molecular and Cell Biology, University of Porto, Porto, Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: Magro
authors.affiliation: Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, and Université Henri Poincaré 1,Vandoeuvre-lès-Nancy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
authors.affiliation: Department of Gastroenterology, AP-HP, Hôpital Saint-Antoine F-75012 and ERL 1057 INSERM/UMRS 7203, UPMC Univ Paris 06F-75005, Paris, France.
authors.forename: Harry
authors.initials: H
authors.lastname: Sokol
authors.affiliation: Department of Gastroenterology of University Hospital Doctor Josep Trueta de Girona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Aldeger
authors.affiliation: Department of Gynecology and Obstetrics Department, Centro Hospitalar S. João, Portugal, and Faculty of Medicine, Porto University, Porto, Portugal.
authors.forename: Antonia
authors.initials: A
authors.lastname: Costa
authors.affiliation: Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Higgins
authors.affiliation: Department of Dermatology, Medical College of Wisconsin, WI, USA.
authors.forename: Joel C
authors.initials: JC
authors.lastname: Joyce
authors.affiliation: Department of Internal Medicine & Hepato-Gastroenterology Unit, Medical School University of Ioannina, Ioannina, Greece.
authors.forename: Konstantinos H
authors.initials: KH
authors.lastname: Katsanos
authors.affiliation: Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, and Université Henri Poincaré 1,Vandoeuvre-lès-Nancy, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Lopez
authors.affiliation: Departement of Biology, University of Girona, Girona, Spain.
authors.forename: Teresa Mas
authors.initials: TM
authors.lastname: de Xaxars
authors.affiliation: Gastroenterology and Hepatology Center, University Hospital Sf. Spiridon, and University of Medicine and Pharmacy Gr. T. Popa, Iasi, Romania.
authors.forename: Elena
authors.initials: E
authors.lastname: Toader
authors.affiliation: Department of Gastroenterology, AP-HP, Hôpital Saint-Antoine F-75012 and ERL 1057 INSERM/UMRS 7203, UPMC Univ Paris 06F-75005, Paris, France. Electronic address: laurent.beaugerie@sat.aphp.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Beaugerie
mesh_terms: D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003226:Congresses as Topic; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control
chemical_list: D007166:Immunosuppressive Agents
keywords: Anti-TNF therapy; BCC; CD; CIN; COC; Cervical intra-epithelial neoplasia; Combination oral contraceptive; Crohn's disease; EBV; Epstein–Barr Virus; Extraintestinal cancers; HLH; HPV; HSTCL; Haemophagocytic lymphohystiocytosis; Hepatosplenic T-cell lymphoma; Human papilloma virus; IBD; Immunosuppressive therapy; Inflammatory bowel diseases; LD; Lymphomas; OR; Odds ratio; PaP; Papanicolaou; SCC; SIR; Skin cancers; Squamous cell carcinoma; Standardized incidence ratio; Thiopurines; UC; UV; Ulcerative colitis; Ultraviolet; Uterine cervix cancers; X-linked lymphoproliferative syndrome; XLP syndrome; basal cell carcinoma; lymphoproliferative disorder