This article is more than 5 years old. Information may no longer be current.
Nonmelanoma skin cancer risk slightly elevated in IBD patients treated with thiopurines
Click Here to Manage Email Alerts
Patients with inflammatory bowel disease who were treated with thiopurines had a modestly elevated risk for developing nonmelanoma skin cancer, according to recent study results.
Researchers in the United Kingdom searched electronic databases, including PubMed, Ovid, the Cochrane Library, Embase and Cumulative Index to Nursing and Allied Health, through October 2012 for reports on the risk for nonmelanoma skin cancer (NMSC) in patients with inflammatory bowel disease (IBD) on thiopurine therapy compared with controls.
Data on the risk for developing NMSC were evident in eight studies involving 60,351 patients. Patients with IBD on thiopurines had a pooled adjusted hazard ratio of 2.28 (95% CI, 1.5-3.45) for NMSC. Significant heterogeneity (I2=76%) was observed between studies with no evidence of publication bias.
Hospital-based studies showed a much greater pooled adjusted hazard ratio (aHR=7.22; 95% CI, 3.08-16.9) when compared with population-based studies (aHR=1.83; 95% CI, 1.2-2.8). Greater risks for NMSCs in patients exposed to thiopurines were reported in studies with shorter duration of follow-up (<3 years), compared with longer mean follow-up duration studies (>6 years), which had a nonsignificant rise in risk for NMSCs with thiopurines.
“The difference in pooled risk between population-based and hospital-based studies suggests the possibility that ascertainment bias could have contributed to this increased risk,” the researchers concluded. “Clinical guidelines for the management of IBD in the United Kingdom emphasize the risk of NMSC in patients treated with thiopurines. There is not enough evidence to suggest that the increased risk of NMSC outweighs the benefit of thiopurines in IBD.”
Disclosure: Jonathan Ariyaratnam, MB, BChir, was awarded a NIHR Academic Foundation Trainee fellowship from the National Institute of Health Research, UK.
Click Here to Manage Email Alerts