Su1267 Poor Recognition and Management of Iron Deficiency Anemia in Inflammatory Bowel Disease: A Missed Opportunity

Abstract

G A A b st ra ct s the 130 IBD-K patients, cancer involved: the gastrointestinal (GI) (41%;n=53) or genitourinary tract (21%;n=27;urinary n=17), the lung (9.2%;n=12),skin (9.2%;n=12: 4 NMSC, 6 melanoma, 2 Kaposi), breast (6.1%;n=8), lymphoma (4.6%,n=6 only in CD: 4 NHL, IS in 4/6, IS+anti-TNFs 1/6), others (8.4%; n=11). The 53 GI tract cancers included: 35 (66%) colorectal (CRC),6 ileal (11%), 11 (23%) others. GI and genitourinary tract cancers were the first and, respectively, the second more frequent cancer in IBD (p<0.0001 vs others). Cancer sites were comparable in UC vs CD: GI (51% vs 34%), genitourinary tract (17% vs 23%), skin (7% vs 10%), lung (11% vs 8%), breast (6% vs 6%), lymphoma (0 vs 10%;p= ns all), respectively. CRC, including 35/53 (66%) GI cancers,were more frequent in UC vs CD (63% vs 37%;p<0.0001). In CD, the percentage of patients with perforating CD was higher in those developing any cancer (CD-K vs CD-C:29% vs 16%;p=0.01). In UC, the percentage of patients with pancolitis was higher in patients developing any cancer (UC-K vs UC-C: 60% vs 34%;p=0.006). Risk factors for any cancer included perforating behavior in CD (OR 2.94; 95% CI 1.25-7.11), pancolitis in UC (2.95;95% CI 1.35-6.71), but not IS and/or anti-TNFs use (CD:OR 1.77;95% CI 0.95-3.36;UC:OR 0.91; 95% CI 0.31-2.80) in IBD. Age, active smoking, IBD duration, IS and/or anti-TNFs use did not increase the overall cancer risk. CONCLUSIONS. In a prospective multicenter study, clinical characteristics, severity and phenotype of IBD appeared to significantly influence the overall cancer risk in IBD. Pancolitis in UC and penetrating behavior in CD were significant risk factors for any cancer.