Abstract
The cancer risk of patients with inflammatory bowel diseases (IBD) has not been well documented in southern Europe. This study aimed to evaluate the overall pattern of cancer risk among patients with IBD in Friuli Venezia Giulia, northeastern Italy. A population-based cohort study was performed through a record linkage between local healthcare databases and the cancer registry (1995–2013). We identified 3664 IBD patients aged 18–84 years, including 2358 with ulcerative colitis (UC) and 1306 with Crohn’s disease (CD). Sex- and age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were used to compare the cancer incidence of IBD patients with the general population. The cumulative cancer risk among IBD patients reached about 10% after 10 years of follow-up. A total of 246 cancers occurred among UC patients (SIR = 1.05, 95% CI: 0.92–1.19), and 141 among CD patients (SIR = 1.20, 95% CI: 1.01–1.41). As compared with the general population, no increased risk of colorectal cancers was observed for either UC or CD patients, whereas the risk of anal cancer was significantly elevated among UC patients (SIR = 6.03, 95% CI: 1.24–17.60). Increased risks were seen for specific extra-intestinal cancers, including corpus uteri (SIR = 2.67, 95% CI: 1.07–5.50) and kidney (SIR = 2.06, 95% CI: 1.03–3.69) among UC patients; thyroid (SIR = 5.58, 95% CI: 2.41–11.00) and skin non-melanoma (SIR = 1.86, 95% CI: 1.32–2.55) among CD patients. This population-based study showed that both UC and CD patients had a colorectal cancer risk similar to that of the general population. However, they were at a higher risk of developing certain extra-intestinal cancer types. Although detection biases cannot be excluded, the study findings pointed to a role of long-standing exposures to immunosuppressive therapies, underlying disease status, as well as the interactions with lifestyle factors. Our findings lent additional support to the need for monitoring the cancer burden in this at-risk population.
Highlights
Inflammatory bowel diseases (IBD), consisting of ulcerative colitis (UC) and Crohn’s disease (CD), are characterized by chronic inflammation of the gastrointestinal wall in genetically susceptible subjects who are exposed to environmental risk factors [1]
No differences emerged for colorectal, extra-intestinal digestive, respiratory tract, and urinary tract cancers. The results of this population-based cohort study indicate that the cumulative risk of cancer among IBD patients reached about 10% after 10 years of follow-up, corresponding to a slight increase in cancer risk compared to the background population
The colorectal cancers (CRC) risk among both UC and CD patients was similar to that expected in the general population, whereas among UC patients the risk of anal cancer was significantly higher
Summary
Inflammatory bowel diseases (IBD), consisting of ulcerative colitis (UC) and Crohn’s disease (CD), are characterized by chronic inflammation of the gastrointestinal wall in genetically susceptible subjects who are exposed to environmental risk factors [1]. It is recognized that patients with IBD are at increased risk of developing intestinal cancers, as a result of chronic intestinal inflammation [3]. According to the most recent meta-analysis of population-based studies, the risk of developing colorectal cancers (CRC) in patients with both CD and UC was 1.7-fold higher than in the general population [4]. The latest population-based studies have shown either lack of CRC excess risks in IBD [5,6,7,8,9], or excess risks restricted to specific subgroup of patients [10,11,12]. To CRC, patients with IBD are at increased risk of small bowel adenocarcinoma [5,13], ileo-anal pouch and rectal cuff cancer, and anal/perianal fistula cancers [7,14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
