title: Mouth cancer in inflammatory bowel diseases.
abstract: Mouth cancer is a major health problem. Multiple risk factors for developing mouth cancer have been studied and include history of tobacco and alcohol abuse, age over 40, exposure to ultraviolet radiation, human papilloma virus infection (HPV), nutritional deficiencies, chronic irritation, and existence or oral potentially malignant lesions such as leukoplakia and lichen planus. An important risk factor for mouth cancer is chronic immunosuppression and has been extensively reported after solid organ transplantation as well as HIV-infected patients. Diagnosis of inflammatory bowel disease (IBD) is not yet considered as a risk factor for oral cancer development. However, a significant number of patients with IBD are receiving immunosuppressants and biological therapies which could represent potential oral oncogenic factors either by direct oncogenic effect or by continuous immunosuppression favoring carcinogenesis, especially in patients with HPV(+) IBD. Education on modifiable risk behaviors in patients with IBD is the cornerstone of prevention of mouth cancer. Oral screening should be performed for all patients with IBD, especially those who are about to start an immunosuppressant or a biologic.
authors.affiliation: Division of Gastroenterology, School of Health Sciences, University of Ioannina, Ioannina, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Giagkou
authors.affiliation: Division of Gastroenterology, School of Health Sciences, University of Ioannina, Ioannina, Greece.
authors.forename: D K
authors.initials: DK
authors.lastname: Christodoulou
authors.affiliation: Division of Gastroenterology, School of Health Sciences, University of Ioannina, Ioannina, Greece.
authors.forename: K H
authors.initials: KH
authors.lastname: Katsanos
mesh_terms: D002180:Candidiasis, Oral / Q000453:epidemiology; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000453:epidemiology*; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D030361:Papillomavirus Infections / Q000453:epidemiology; D011230:Precancerous Conditions / Q000453:epidemiology*; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents
keywords: azathioprine; biological therapy; immunosuppressant; inflammatory bowel disease; mouth cancer; mouth precancerous lesions