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Age, immunomodulator use increase cancer risk in IBD patients

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Thomas Greuter

Older patients with inflammatory bowel disease who have recently taken immunomodulators were more likely to have or develop cancer, according to research presented at the Congress of the European Crohn’s and Colitis Organisation.

Thomas Greuter, MD, of the division of gastroenterology and hepatology at the University Hospital of Zurich in Switzerland, and colleagues also found that biologics and aminosalicylates (5-ASA) were protective factors against cancer risk.

The researchers noted that while cancer risk is a known long-term complication of inflammatory bowel disease (IBD), the existing data remain inconsistent.

“While the association with cancer is well established for some risk factors, for others, data are rather limited,” Greuter told Healio Gastroenterology and Liver Disease. “In addition, recent publications have shown decreasing trends for colorectal carcinoma incidence, but trends for other cancer subtypes remain unknown.”

Greuter and colleagues analyzed patients in a Swiss IBD cohort both from a cross-sectional perspective (n = 3,119) and longitudinally (n = 2,580) to determine the prevalence and incidence of cancer, as well as protective and risk factors.

The investigators identified 122 malignancy cases (3.9%) among the 3,119 patients in the cross-sectional analysis. Patients with cancer were more likely to be undergoing antibiotic and steroid therapy, while biologics therapy was less common. Age (OR = 1.04; P < .001), ulcerative colitis (1.68; P = .03), intestinal surgery (OR = 4.51; P < .001), fistula (OR 1.74; P = .015) and treatment with steroids (OR 2.13; P = .001) were all independent predictors for cancer. The researchers also found that treatment with 5-ASA (OR = 0.61; P = .036) and biologics (OR 0.38; P < .001) were protective factors against cancer.

In the longitudinal portion of the study, the investigators analyzed patients without malignancy at enrollment and a follow-up of at least one year to determine risk and protective factors regarding cancer development. Of 2,580 total patients, 67 (2.6%) developed malignancies over 5 years of follow-up. Greuter and colleagues found that the same risk and protective factors remained in the second cohort.

“Compared to the general population, all cancer incidence and incidence for colorectal carcinoma were not increased,” Greuter said. “However, IBD patients were at increased risk for lymphoma and biliary cancer. Age and recent use of immunomodulators were identified as the main risk factors, while aminosalicylates and biologics were protective."

Reference:

Greuter, et al. Abstract OP037; Presented at: Congress of the European Crohn’s and Colitis Organisation; Feb. 14-17; Vienna, Austria.

Disclosures: The authors reported no relevant financial disclosures.