Malignancies in Inflammatory Bowel Disease: Frequency, Incidence and Risk Factors-Results from the Swiss IBD Cohort Study.

Details

Serval ID
serval:BIB_5ABC0B446483
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Malignancies in Inflammatory Bowel Disease: Frequency, Incidence and Risk Factors-Results from the Swiss IBD Cohort Study.
Journal
The American journal of gastroenterology
Author(s)
Scharl S., Barthel C., Rossel J.B., Biedermann L., Misselwitz B., Schoepfer A.M., Straumann A., Vavricka S.R., Rogler G., Scharl M., Greuter T.
ISSN
1572-0241 (Electronic)
ISSN-L
0002-9270
Publication state
Published
Issued date
01/2019
Peer-reviewed
Oui
Volume
114
Number
1
Pages
116-126
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Malignancy may occur as long-term complication of inflammatory bowel disease (IBD) due to different risk factors. We assessed prevalence and incidence of malignancy, and predictive factors in the Swiss IBD Cohort Study (SIBDCS).
All IBD patients in the SIBDCS were analyzed from a cross-sectional and longitudinal perspective. Patients with malignancies were compared to controls. Standardized incidence ratios (SIR) were calculated based on age-specific and sex-specific background rates.
Malignancies were identified in 122 of 3119 patients (3.9%). In a logistic regression model, age (OR 1.04 per year), intestinal surgery (OR 3.34), and treatment with steroids (OR 2.10) were the main predictors for the presence of malignancy, while treatment with 5-ASA (OR 0.57) and biologics (OR 0.38) were protective. From a longitudinal perspective, 67 out of 2580 patients (2.6%) were newly diagnosed with malignancy during a follow-up of 12,420.8 years (median 4.9 years). While there was no increased risk for malignancy overall (SIR 0.93, 95% CI 0.72-1.18) and colorectal cancer (SIR 1.55, 95% CI 0.71-2.95), IBD patients had an increased risk for lymphoma (SIR 2.98, 95% CI 1.36-5.66) and biliary cancer (SIR 6.3, 95% CI 1.27-18.41). In a Cox regression model, age and recent use of immunomodulators were the main predictors for development of malignancies, while 5-ASA, biologics were protective.
IBD patients showed increased risk for lymphoma and biliary cancer, but not colorectal cancer and cancer overall. Age and recent use of immunomodulators were the main risk factors for malignancy, while aminosalicylates and biologics appear to be protective.
Keywords
Adult, Cohort Studies, Colorectal Neoplasms/complications, Colorectal Neoplasms/epidemiology, Cross-Sectional Studies, Female, Humans, Incidence, Inflammatory Bowel Diseases/complications, Inflammatory Bowel Diseases/epidemiology, Longitudinal Studies, Male, Regression Analysis, Risk Factors, Switzerland/epidemiology, Young Adult
Pubmed
Web of science
Create date
29/10/2018 12:44
Last modification date
04/12/2019 6:31
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