Cancer and inflammatory bowel disease in the elderly.
Cancer may be a complication of inflammatory bowel disease (IBD) or its treatments. In older Crohn's disease and ulcerative colitis patients, the risk of malignancy is of particular concern. IBD diagnosis at an advanced age is associated with earlier development of colitis-associated colorectal cancer. Thiopurine use in older IBD patients is tied to an increased risk of non-Hodgkin's lymphoma, nonmelanoma skin cancer, and urinary tract cancers. Additionally, older age is accompanied by multimorbidity, an increased risk of malnutrition, and decreased life expectancy, factors that complicate the management of cancer in the elderly. The optimal approach to the increased risk of malignancy in older age IBD is appropriate cancer screening and medical treatment. This may include age-specific colorectal cancer screening and limiting UV radiation exposure. With a growing number of older IBD patients, further studies are necessary to delineate the risk of cancer in this population.
Division of Gastroenterology, University of Arizona College of Medicine, Tucson, AZ, United States; University of Arizona Center of Aging, Department of Medicine, Tucson, AZ, United States. Electronic address: staleban@yahoo.com.
Sasha
S
Taleban
Hematology/Oncology, University of Arizona College of Medicine, Tucson, AZ, United States.
Emad
E
Elquza
Public Health, Epidemiology and Health Economics, EPIMAD Registery, Regional House of Clinical Research, Regional University Hospital, Lille Cedex, France; Lille Inflammation Research International Center, LIRIC-UMR 995 Inserm, Lille University 2, Lille University Hospital, Lille University, France.
Corinne
C
Gower-Rousseau
Inserm U954 and Department of Gastroenterology, Nancy University Hospital, Lorraine University, Vandœuvre-lès-Nancy, France.
Laurent
L
Peyrin-Biroulet
D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D055088:Early Detection of Cancer; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000139:chemically induced / Q000453:epidemiology*; D015122:Mercaptopurine / Q000009:adverse effects*; D012878:Skin Neoplasms / Q000453:epidemiology; D014571:Urologic Neoplasms / Q000453:epidemiology
D015122:Mercaptopurine
Crohn's disease; Malignancy; Older; Ulcerative colitis