title: Inflammatory Bowel Disease Phenotype as Risk Factor for Cancer in a Prospective Multicentre Nested Case-Control IG-IBD Study.
abstract: OBJECTIVE
  Cancer risk in inflammatory bowel disease [IBD] is still debated. In a prospective, multicentre, nested case-control study, we aimed to characterise incident cases of cancer in IBD. The role of immunomodulators vs clinical characteristics of IBD as risk factors for cancer was also investigated.
  
  
  METHODS
  From January 2012 to December 2014, each IBD patient with incident cancer was matched with two IBD patients without cancer for: IBD type, gender, and age. Risk factors were assessed by multivariate regression analysis.
  
  
  RESULTS
  IBD patients considered numbered 44619: 21953 Crohn's disease [CD], 22666 ulcerative colitis [UC]. Cancer occurred in 174 patients: 99 CD [CD-K], 75 UC [UC-K]. Controls included 198 CD [CD-C], 150 UC [UC-C]. Cancer incidence in IBD was 3.9/1000, 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%], skin [13.2%], urinary tract [12.1%], lung [8.6%], breast [8%], genital tract [6.9%], thyroid [4.6%], lymphoma [3.5%], others [6.3%]. In CD, penetrating behaviour and combined thiopurines and tumour necrosis factor alpha [TNFα] antagonists were risk factors for cancer overall: odds ratio [OR] (95% confidence interval [CI] 2.33 [1.01-5.47]); 1.97 [1.1-3.5]; and for extracolonic cancers 3.9 [1.56-10.1]; 2.15 [1.17-4.1], respectively. In UC, risk factors were pancolitis and disease-related surgery for cancer overall (OR: 2.52 [1.26-5.1]; 5.09 [1.73-17.1]); disease-related surgery for colorectal cancer [CRC] (OR 3.6 [1.0-12]); and extensive and left-sided vs distal UC for extracolonic cancers (OR: 2.55 [1.15-5.9]; 2.6 [1.04-6.6]), respectively.
  
  
  CONCLUSIONS
  In a multicentre study, penetrating CD and extensive UC were risk factors for cancer overall. Cancer incidence was higher in CD than in UC.
authors.affiliation: Department of Systems Medicine, Gastroenterology Unit, University 'Tor Vergata', Rome, Italy biancone@med.uniroma2.it.
authors.forename: Livia
authors.initials: L
authors.lastname: Biancone
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Columbus, Catholic University and IBD Unit, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Armuzzi
authors.affiliation: GI Unit, A.O. San Camillo-Forlanini, IBD Unit, Rome, Italy.
authors.forename: Maria Lia
authors.initials: ML
authors.lastname: Scribano
authors.affiliation: Department of Gastroenterology, U.O. Gastroenterology, University of Padua, Padua, Italy.
authors.forename: Renata
authors.initials: R
authors.lastname: D'Inca
authors.affiliation: Department of Gastroenterology, University 'Federico II', Naples, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Castiglione
authors.affiliation: IBD Unit, S. Filippo Neri Hospital, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Papi
authors.affiliation: Department of Systems Medicine, Gastroenterology Unit, University 'Tor Vergata', Rome, Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Angelucci
authors.affiliation: GI Unit, A.O. Ordine Mauriziano di Torino, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Daperno
authors.affiliation: GI Unit, ARNAS Civico-DI Cristina Benfratelli, Palermo, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Mocciaro
authors.affiliation: GI Unit, SUN, II University of Naples, Naples, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Riegler
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Fries
authors.affiliation: Department of Pediatry, GI Unit, `Maggiore Hospital', Bologna, Italy.
authors.forename: Gianmichele
authors.initials: G
authors.lastname: Meucci
authors.affiliation: GI Unit, 'Maggiore Hospital', Bologna, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Alvisi
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, and GI Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Spina
authors.affiliation: GI Unit, Hospital 'Fatebenefratelli', Milan, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Ardizzone
authors.affiliation: Department of Systems Medicine, Gastroenterology Unit, University 'Tor Vergata', Rome, Italy.
authors.forename: Carmelina
authors.initials: C
authors.lastname: Petruzziello
authors.affiliation: Department of Systems Medicine, Gastroenterology Unit, University 'Tor Vergata', Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ruffa
authors.affiliation: GI Unit, A.O. San Camillo-Forlanini, IBD Unit, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Kohn
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, and GI Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Vecchi
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Columbus, Catholic University and IBD Unit, Rome, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Guidi
authors.affiliation: GI Unit, ARNAS Civico-DI Cristina Benfratelli, Palermo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Di Mitri
authors.affiliation: Division of Internal Medicine 'Villa Sofia-Cervello' Hospital, University of Palermo, Palermo, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Renna
authors.affiliation: Department of Systems Medicine, Gastroenterology Unit, University 'Tor Vergata', Rome, Italy.
authors.forename: Calabrese
authors.initials: C
authors.lastname: Emma
authors.affiliation: Department of Medical and Surgical Specialties, Gastroenterology SOD2, A.O. Universitaria Careggi, Florence, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Rogai
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Division of Internal Medicine 'Villa Sofia-Cervello' Hospital, University of Palermo, Palermo, Italy.
authors.forename: Ambrogio
authors.initials: A
authors.lastname: Orlando
authors.affiliation: Department of Systems Medicine, Gastroenterology Unit, University 'Tor Vergata', Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pallone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology*; D010641:Phenotype; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007155:Immunologic Factors
keywords: Inflammatory bowel disease; cancer risk; phenotype