INFLAMMATORY BOWEL DISEASE PHENOTYPE AS RISK FACTOR FOR CANCER IN A PROSPECTIVE MULTICENTER NESTED CASE-CONTROL IG-IBD STUDY.

BACKGROUND AND AIMS CANCER RISK IN Inflammatory Bowel Disease (IBD) is STILL DEBATED: . In a prospective, multicenter, nested case-control study, we aimed to characterize incident cases of cancer in IBD. The ROLE OF IMMUNOMODULATORS VERSUS CLINICAL CHARACTERISTICS OF IBD AS RISK FACTORS FOR CANCER WAS ALSO INVESTIGATED: . MATERIALS AND METHODS: From January 2012 to December 2014, each IBD patient with incident cancer was matched with 2 IBD patients without cancer for: IBD type, gender, age. Risk factors were assessed by multivariate regression analysis. RESULTS: IBD patients considered were 44,619: 21,953 Crohn's Disease (CD), 22,666 Ulcerative Colitis (UC). CANCER OCCURRED IN 174 PATIENTS: 99 CD (CD-K), 75 UC (UC-K). CONTROLS INCLUDED 198 CD CD-C, 150 UC UC-C: . Cancer incidence in IBD was 3.9/1000, higher in CD (4.5/1000 [99/21,953]) than in UC (3.3/1000 [75/22,666]; p=0.042). Cancers involved: digestive system (36.8%), skin (13.2%), urinary TRACT: (12.1%), lung (8.6%), breast (8%), genital tract (6.9%), thyroid (4.6%), lymphoma (3.5%), others (6.3%). In CD, penetrating behavior and combined thiopurines and TNFα antagonists were risk factors for cancer overall (OR [95% CI]: 2.33 [1.01-5.47]; 1.97 [1.1-3.5]) and for extracolonic cancers (OR 3.9 [1.56-10.1]; 2.15 [1.17-4.1]). IN UC: , risk factors were: pancolitis and DISEASE-RELATED: surgery for cancer overall (OR: 2.52 [1.26-5.1]; 5.09 [1.73-17.1]); disease-related surgery for CRC (OR 3.6 [1.0-12]); extensive and left-sided vs distal UC for extracolonic cancers (OR: 2.55 [1.15-5.9]; 2.6 [1.04-6.6]). CONCLUSIONS: In a multicenter study, penetrating CD and extensive UC WERE: risk factors for cancer overall. Cancer INCIDENCE WAS HIGHER IN CD THAN IN UC: .