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Fistulizing pattern in Crohn's disease and pancolitis in ulcerative colitis are independent risk factors for cancer: a single-center cohort study.
J Crohns Colitis. 2012 Jun; 6(5):578-87.JC

Abstract

BACKGROUND & AIMS

The combined role of immunomodulators (IMM) and clinical characteristics of Inflammatory Bowel Disease (IBD) in determining the cancer risk is undefined. The aim was to assess whether clinical characteristics of IBD are independent risk factors for cancer, when considering thiopurines and anti-TNFs use.

METHODS

In a single-center cohort study, clinical characteristics of IBD patients with IBD duration ≥1 year and ≥2 visits from 2000 to 2009 were considered. Tests for crude rates and survival analysis methods were used to assess differences of incidence of cancer between groups. The methods were adjusted for the time interval between diagnosis and immunomodulatory treatments.

RESULTS

IBD population included 1222 patients :615 Crohn's disease (CD), 607 ulcerative colitis (UC). Cancer was diagnosed in 51 patients (34 CD,17 UC), with an incidence rate of 4.3/1000 pt/year. The incidence rate of cancer was comparable between CD and UC (4.6/1000 pt/year vs 2.9/1000 pt/year ;p=n.s.). Cancer most frequently involved the breast, the GI tract, the skin. Lymphoma was diagnosed in CD (1HL, 1NHL,0 HSTCL). Risk factors for cancer included older age at diagnosis of IBD (CD: HR 1.25;95%CI 1.08-1.45; UC:HR 1.33;95%CI 1.15-1.55 for an increase by 5 years; p=0.0023; p=0.0002), fistulizing pattern in CD (HR 2.55; 95%CI 1.11-5.86,p=0.0275), pancolitis in UC (HR 2.79;95%CI 1.05-7.40 p=0.0396 vs distal). IMM and anti-TNFs did not increase the cancer risk in CD, neither IMM in UC (anti-TNFs risk in UC not feasible as no cases observed).

CONCLUSIONS

Fistulizing pattern in CD, pancolitis in UC and older age at diagnosis of IBD are independent risk factors for cancer.

Authors+Show Affiliations

Cattedra di Gastroenterologia e Bioinformatica, Università Tor Vergata, Roma, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22398047

Citation

Biancone, Livia, et al. "Fistulizing Pattern in Crohn's Disease and Pancolitis in Ulcerative Colitis Are Independent Risk Factors for Cancer: a Single-center Cohort Study." Journal of Crohn's & Colitis, vol. 6, no. 5, 2012, pp. 578-87.
Biancone L, Zuzzi S, Ranieri M, et al. Fistulizing pattern in Crohn's disease and pancolitis in ulcerative colitis are independent risk factors for cancer: a single-center cohort study. J Crohns Colitis. 2012;6(5):578-87.
Biancone, L., Zuzzi, S., Ranieri, M., Petruzziello, C., Calabrese, E., Onali, S., Ascolani, M., Zorzi, F., Condino, G., Iacobelli, S., & Pallone, F. (2012). Fistulizing pattern in Crohn's disease and pancolitis in ulcerative colitis are independent risk factors for cancer: a single-center cohort study. Journal of Crohn's & Colitis, 6(5), 578-87. https://doi.org/10.1016/j.crohns.2011.11.005
Biancone L, et al. Fistulizing Pattern in Crohn's Disease and Pancolitis in Ulcerative Colitis Are Independent Risk Factors for Cancer: a Single-center Cohort Study. J Crohns Colitis. 2012;6(5):578-87. PubMed PMID: 22398047.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fistulizing pattern in Crohn's disease and pancolitis in ulcerative colitis are independent risk factors for cancer: a single-center cohort study. AU - Biancone,Livia, AU - Zuzzi,Sara, AU - Ranieri,Micaela, AU - Petruzziello,Carmelina, AU - Calabrese,Emma, AU - Onali,Sara, AU - Ascolani,Marta, AU - Zorzi,Francesca, AU - Condino,Giovanna, AU - Iacobelli,Simona, AU - Pallone,Francesco, Y1 - 2011/12/20/ PY - 2011/07/22/received PY - 2011/10/23/revised PY - 2011/11/09/accepted PY - 2012/3/9/entrez PY - 2012/3/9/pubmed PY - 2012/12/10/medline SP - 578 EP - 87 JF - Journal of Crohn's & colitis JO - J Crohns Colitis VL - 6 IS - 5 N2 - BACKGROUND & AIMS: The combined role of immunomodulators (IMM) and clinical characteristics of Inflammatory Bowel Disease (IBD) in determining the cancer risk is undefined. The aim was to assess whether clinical characteristics of IBD are independent risk factors for cancer, when considering thiopurines and anti-TNFs use. METHODS: In a single-center cohort study, clinical characteristics of IBD patients with IBD duration ≥1 year and ≥2 visits from 2000 to 2009 were considered. Tests for crude rates and survival analysis methods were used to assess differences of incidence of cancer between groups. The methods were adjusted for the time interval between diagnosis and immunomodulatory treatments. RESULTS: IBD population included 1222 patients :615 Crohn's disease (CD), 607 ulcerative colitis (UC). Cancer was diagnosed in 51 patients (34 CD,17 UC), with an incidence rate of 4.3/1000 pt/year. The incidence rate of cancer was comparable between CD and UC (4.6/1000 pt/year vs 2.9/1000 pt/year ;p=n.s.). Cancer most frequently involved the breast, the GI tract, the skin. Lymphoma was diagnosed in CD (1HL, 1NHL,0 HSTCL). Risk factors for cancer included older age at diagnosis of IBD (CD: HR 1.25;95%CI 1.08-1.45; UC:HR 1.33;95%CI 1.15-1.55 for an increase by 5 years; p=0.0023; p=0.0002), fistulizing pattern in CD (HR 2.55; 95%CI 1.11-5.86,p=0.0275), pancolitis in UC (HR 2.79;95%CI 1.05-7.40 p=0.0396 vs distal). IMM and anti-TNFs did not increase the cancer risk in CD, neither IMM in UC (anti-TNFs risk in UC not feasible as no cases observed). CONCLUSIONS: Fistulizing pattern in CD, pancolitis in UC and older age at diagnosis of IBD are independent risk factors for cancer. SN - 1876-4479 UR - https://www.unboundmedicine.com/medline/citation/22398047/Fistulizing_pattern_in_Crohn's_disease_and_pancolitis_in_ulcerative_colitis_are_independent_risk_factors_for_cancer:_a_single_center_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1873-9946(11)00319-9 DB - PRIME DP - Unbound Medicine ER -