S0660 Odds of Developing of Extra-Intestinal Cancers in Patients With Inflammatory Bowel Disease in the U.S.: A Population-Based Study

Abstract

INTRODUCTION: Inflammatory Bowel Disease (IBD) patients are at an increased risk of gastrointestinal cancers due to chronic intestinal inflammation. However, the relationship between IBD and extra-intestinal cancers is not well established. We sought to investigate the association between IBD and lesser known extra-intestinal cancers in a large population database. METHODS: We used a commercial database (Explorys Inc, Cleveland, OH) which includes electronic health record data from 26 major integrated US healthcare systems. Based on Systematized Nomenclature Of Medicine—Clinical Terms (SNOMED-CT), we identified all patients who were diagnosed with IBD between 1999 and 2020. We investigated the prevalence of extra-intestinal cancers (thyroid, breast, lung and kidney) in patients with and without IBD. RESULTS: Of the 61,633,690 individuals in the database, we identified 184,390 (0.3%) individuals with CD and 147,420 (0.24%) patients with UC, and 61,030,220 (99.46%) individuals without IBD. The odds of extra-intestinal cancers in individuals with CD and UC were as follows. Compared to the overall population, CD and UC patients were 2.5 times [OR: 2.47, 95% CI 2.30–2.66, P < 0.001] and 2.4 times [OR: 2.47, 95% CI 2.30–2.66, P < 0.001] more likely to have thyroid cancer. In lung cancer, CD and UC patients were 2 times [OR: 1.99, 95% CI 1.90–2.09, P < 0.001] and 7 times [OR: 7.03, 95% CI 6.83–7.23, P < 0.001] more likely to have lung cancer. In breast cancer, CD and UC patients were 2.0 times [OR: 1.95, 95% CI 1.95–2.01, P < 0.001] and 2.7 times [OR: 2.72, 95% CI 2.64–2.82, P < 0.001] more likely to have breast cancer. In renal cancer, CD and UC patients were 3.0 times [OR: 2.95, 95% CI 2.77–3.15, P < 0.001] and 3.1 times [OR: 3.09, 95% CI 2.88–3.32, P < 0.001] more likely to have renal cancer. CONCLUSION: In this large study, we found that patients with CD and UC were significantly more likely to be associated with extra-intestinal cancers. Further studies are needed to confirm these findings and investigate the role of extra-intestinal cancer screening in patients with IBD.Figure 1.: Prevalence of Extra-intestinal cancers in patients with and without IBDTable 1.: Table of Extra-intestinal cancers in patients with and without IBD