Malignancies in Patients with Inflammatory Bowel Disease: A Single-Centre Experience.
BACKGROUND
Gastrointestinal and extraintestinal malignancies are long-term complications in patients with inflammatory bowel disease (IBD), likely as a result of chronic inflammation and the use of immunosuppressive medications used to control inflammation. Here, we assessed the frequency of malignancies in a large tertiary IBD centre at the University Hospital Zurich.


METHODS
We performed a retrospective analysis of data from 1,026 patients from our IBD clinic treated between 2007 and 2014.


RESULTS
Twenty two of the 1,026 patients developed 28 cases of malignancies, 14 patients were male and 8 patients female. The median latency between IBD diagnosis and first malignancy was 13 years (range 2-27 years). Most common malignancies were non-Hodgkin lymphoma, colorectal cancer (CRC), urothelial carcinoma, cholangiocellular carcinoma (CCC) and prostate cancer. The most common tumour type in Crohn's disease patients (13/22) was lymphoma (5 cases), in ulcerative colitis patients (9/22) CCC (2 cases) and CRC (2 cases). The observed incidence of lymphoma (32.5/100,000), bladder carcinoma (21.7/100,000) and CCC (10.8/100,000) was higher than expected and known from general population. All of the patients that developed a malignancy had received immunosuppressive therapy. Compared to a cohort of 927 IBD patients without malignancies there were no statistical differences regarding gender, antibodies targeting tumour necrosis factor and thiopurine use.


CONCLUSIONS
Our data support the assumption that a long-standing disease course and immunosuppressive therapy increase the risk for developing malignancies in IBD patients.
Division of Gastroenterology and Hepatology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Mehdi
M
Madanchi
Jonas
J
Zeitz
Christiane
C
Barthel
Panagiotis
P
Samaras
Sylvie
S
Scharl
Michael C
MC
Sulz
Luc
L
Biedermann
Pascal
P
Frei
Stephan R
SR
Vavricka
Gerhard
G
Rogler
Michael
M
Scharl
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000453:epidemiology* / Q000209:etiology; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology* / Q000209:etiology; D018281:Cholangiocarcinoma / Q000453:epidemiology* / Q000209:etiology; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
D007166:Immunosuppressive Agents