Risk Factors for Intestinal and Extraintestinal Cancers in Inflammatory Bowel Disease: A Retrospective Single-Center Cohort Study
Simple Summary
Abstract
1. Introduction
2. Materials and Methods
3. Results
3.1. Baseline Characteristics of IBD Patients
3.2. Overall Cancer Occurrence in IBD Patients
3.3. Immunomodulatory Treatments in IBD Patients
- (1)
- 15 patients (50%) with therapy duration of less than 5 years (median 2 years, range 0.5–4 years),
- (2)
- 8 patients (27%) with therapy duration between 5 and 10 years (median 7.5 years, range 4–9 years)
- (3)
- 7 patients (23%) with therapy duration exceeding 10 years (median 13.5 years, range 12–21 years).
3.4. Risk Factors for Cancer Occurrence in IBD Patients
3.5. SIR
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
IBD | Inflammatory bowel disease |
UC | Ulcerative colitis |
CD | Crohn’s disease |
CRC | Colorectal cancer |
PSC | Primary sclerosing cholangitis |
5-ASA | 5-Aminosalicylates |
ECCO | European Crohn’s and Colitis Organization |
AZA | Azathioprine |
6-MP | 6-mercaptopurine |
MTX | Methotrexate |
anti-TNFα | Infliximab, Adalimumab, Golimumab |
IFX | Infliximab |
ADA | Adalimumab |
GLM | Golimumab |
VDZ | Vedolizumab |
UST | Ustekinumab |
IQR | Interquartile range |
HR | Hazard ratio |
CI | Confidence interval |
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IBD (560) | CD (310) | UC (250) | p | |
---|---|---|---|---|
Age at IBD diagnosis, median [range], y | 31 (6–76) | 30 (6–70) | 32 (5–76) | 0.1 |
IBD duration **, median [range], y | 14 (1–53) | 14 (1–53) | 15 (5–52) | 0.1 |
Median follow-up ^, median [range], y | 10 (1–26) | 9 (1–23) | 10 (4–26) | 0.1 |
Gender, No. (%) | ||||
females | 303 (54%) | 180 (58%) | 123 (49%) | 0.03 |
males | 257 (46%) | 130 (42%) | 127 (51%) | |
Smoking habits (%) | ||||
current | 116 (21%) | 97 (31%) | 19 (8%) | <0.001 * |
never | 279 (50%) | 124 (40%) | 155 (62%) | <0.001 * |
former smoker | 41 (7%) | 16 (5%) | 25 (10%) | 0.03 * |
not specified | 124 (22%) | 73 (24%) | 51 (20%) | 0.3 |
Alcohol intake (%) | ||||
current | 26 (5%) | 17 (5%) | 9 (4%) | 0.2 |
never | 389 (69%) | 206 (67%) | 183 (73%) | 0.08 |
former | 6 (1%) | 4 (1%) | 2 (1) | 0.5 |
not specified | 139 (25%) | 83 (27%) | 56 (22%) | 0.2 |
Montreal Classification | ||||
a L1 84 (28%) | b E1 34(13%) | |||
L2 108 (35%) | E2 121 (48%) | |||
L3 79 (25%) | E3 87 (35%) | |||
L4 39 (12%) | - | |||
c B1 169 (55%) | - | |||
B2 71 (23%) | ||||
B3/p 70 (22) | - | |||
Disease activity | ||||
remission | d 155 (50%) | e 60 (24%) | <0.001 * | |
mild | 73 (23%) | 140 (56%) | <0.001 * | |
moderate | 77 (25%) | 50 (20%) | 0.1 | |
severe | 5 (2%) | 0 | ||
Extra-intestinal manifestations | 187 (33%) | 101 (32%) | 86 (34%) | 0.6 |
joints lesions | 88 (47%) | 36 (36%) | 52 (60%) | 0.002 * |
skin lesions | 58 (31%) | 41 (40%) | 17 (20%) | 0.01 * |
eyes lesions | 14 (7%) | 7 (7%) | 7 (8%) | 0.6 |
kidneys lesions | 5 (3%) | 5 (5%) | 0 | |
liver lesions | 22 (12%) | 12 (12%) | 10 (12%) | 0.9 |
IBD-related surgery, No. (%) | 182 (32%) | 167 (54%) | 15 (6%) | <0.001 * |
Variables | HRunivariate (95% CI) | HRmultivariate (95% CI) |
---|---|---|
Age | 1.07 (1.04–1.09) a | 1.06 (1.03–1.09) a |
Female sex | 1.42 (0.7–2.8) | 1.65 (0.7–3.8) |
Smoking habits | ||
Never | 1.0 (ref.) | 1.0 (ref.) |
Yes | 1.71 (0.6–4.2) | 1.41 (0.2–9.4) |
In the past | 1.89 (0.6–5.4) | 2.30 (0.7–7.5) |
Alcohol intake | ||
Never | 1.0 (ref.) | 1.0 (ref.) |
Yes | 1.39 (0.1–10.3) | 1.35 (0.1–15.3) |
In the past | NA b | NA |
Extraintestinal manifestations | 0.22 (0.07–0.7) a | 0.08 (0.01–0.4) a |
Medication | ||
Combination therapy vs. monotherapy c | 4.73 (2.001–11.2) a | 12.77 (2.3–70.5) a |
Monotherapy | ||
5-Aminosalysilate | 0.58 (0.3–1.1) | - |
Steroid | 0.01 (0.001–0.1) a | - |
IM d | 8.42 (4.04–17.5) a | - |
anti-TNFα e | 1.12 (0.5–2.2) | - |
Vedolizumab | 1.14 (0.2–4.8) | - |
Ustekinumab | 3.32 (1.1–9.7) a | - |
Combination therapy c | ||
IM + anti-TNFα e | 10.07 (4.1–24.6) a | - |
IM + Vedolizumab | 1.56 (0.2–11.5) | - |
IM + Ustekinumab | 0.04 (0.001–2496.4) | - |
Cancers (Total) | Observed Cases | Expected Case/Year | Expected Case/Follow Up | SIR | 95% CI |
---|---|---|---|---|---|
Lymphoma | 3 | 0.016 | 0.147 | 20.41 | 4.2–59.6 |
CML | 1 | 0.053 | 0.489 | 2.040 | 0.05–11.4 |
CRC | 11 | 0.233 | 2.167 | 5.07 | 2.5–9.09 |
Anus | 1 | 0.011 | 0.101 | 9.89 | 0.2–54.7 |
Basalioma | 5 | 0.762 | 7.087 | 0.70 | 0.2–1.6 |
Melanoma | 3 | 0.109 | 1.015 | 2.95 | 0.6–8.6 |
Prostate | 2 | 0.255 | 2.369 | 0.84 | 0.1–3.09 |
Lung | 1 | 0.238 | 2.209 | 0.45 | 0.01–2.5 |
Breast | 7 | 0.344 | 3.199 | 2.18 | 0.8–4.4 |
Thyroid | 1 | 0.038 | 0.350 | 2.86 | 0.07–15.8 |
Uterus | 2 | 0.048 | 0.448 | 4.46 | 0.5–15.8 |
Pancreas | 2 | 0.072 | 0.665 | 3.00 | 0.3–10.8 |
CCC | 1 | 0.018 | 0.168 | 5.94 | 0.1–33.07 |
Ovary | 2 | 0.032 | 0.302 | 6.63 | 0.7–23.5 |
Total | 42 | 2.33 | 21.68 | 1.937 | 1.4–2.6 |
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Rosania, R.; Nord, M.; Scurt, F.G.; Lux, A.; Keitel, V.; von Arnim, U.; Venerito, M. Risk Factors for Intestinal and Extraintestinal Cancers in Inflammatory Bowel Disease: A Retrospective Single-Center Cohort Study. Cancers 2025, 17, 1396. https://doi.org/10.3390/cancers17091396
Rosania R, Nord M, Scurt FG, Lux A, Keitel V, von Arnim U, Venerito M. Risk Factors for Intestinal and Extraintestinal Cancers in Inflammatory Bowel Disease: A Retrospective Single-Center Cohort Study. Cancers. 2025; 17(9):1396. https://doi.org/10.3390/cancers17091396
Chicago/Turabian StyleRosania, Rosa, Maximilian Nord, Florian G. Scurt, Anke Lux, Verena Keitel, Ulrike von Arnim, and Marino Venerito. 2025. "Risk Factors for Intestinal and Extraintestinal Cancers in Inflammatory Bowel Disease: A Retrospective Single-Center Cohort Study" Cancers 17, no. 9: 1396. https://doi.org/10.3390/cancers17091396
APA StyleRosania, R., Nord, M., Scurt, F. G., Lux, A., Keitel, V., von Arnim, U., & Venerito, M. (2025). Risk Factors for Intestinal and Extraintestinal Cancers in Inflammatory Bowel Disease: A Retrospective Single-Center Cohort Study. Cancers, 17(9), 1396. https://doi.org/10.3390/cancers17091396