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Extracolonic Cancer in Inflammatory Bowel Disease: Data from the GETECCU Eneida Registry

2017; Lippincott Williams & Wilkins; Volume: 112; Issue: 7 Linguagem: Inglês

10.1038/ajg.2017.96

1572-0241

María Chaparro, Mercedes Ramas, J M Benítez, Alicia López‐García, Alba Juan Juan, Jordi Guardiola, Miguel Mínguez, Xavier Calvet, Lucía Márquez, Luís Fernández-Salazar, Luís Bujanda, Carlos García, Yamile Zabana, R Lorente, Jesús Barrio, E Hinojosa, Marisa Iborra, Domínguez M Cajal, Manuel Van Domselaar, M F García-Sepulcre, Fernando Gomollón, Marta Piqueras, G Alcaín, Valle García–Sánchez, Julián Panés, Eugeni Domènech, Esther García‐Esquinas, Fernando Rodríguez‐Artalejo, Javier P. Gisbert,

Autoimmune and Inflammatory Disorders

Objectives: The objective of this study was (a) To know the prevalence and distribution of extracolonic cancer (EC) in patients with inflammatory bowel disease (IBD); (b) To estimate the incidence rate of EC; (c) To evaluate the association between EC and treatment with immunosuppressants and anti-tumor necrosis factor (TNF) agents. Methods: This was an observational cohort study. Inclusion criteria: IBD and inclusion in the ENEIDA Project (a prospectively maintained registry) from GETECCU. Exclusion criteria: Patients with EC before the diagnosis of IBD, lack of relevant data for this study, and previous treatment with immunosuppressants other than corticosteroids, thiopurines, methotrexate, or anti-TNF agents. The Kaplan–Meier method was used to evaluate the impact of several variables on the risk of EC, and any differences between survival curves were evaluated using the log-rank test. Stepwise multivariate Cox regression analysis was used to investigate factors potentially associated with the development of EC, including drugs for the treatment of IBD, during follow-up. Results: A total of 11,011 patients met the inclusion criteria and were followed for a median of 98 months. Forty-eight percent of patients (5,303) had been exposed to immunosuppressants or anti-TNF drugs, 45.8% had been exposed to thiopurines, 4.7% to methotrexate, and 21.6% to anti-TNF drugs. The prevalence of EC was 3.6%. In the multivariate analysis, age (HR=1.05, 95% CI=1.04–1.06) and having smoked (hazards ratio (HR)=1.47, 95% confidence interval (CI)=1.10–1.80) were the only variables associated with a higher risk of EC. Conclusions: Neither immunosuppressants nor anti-TNF drugs seem to increase the risk of EC. Older age and smoking were associated with a higher prevalence of EC.