Malignancy and Inflammatory Bowel Disease (IBD): Incidence and Prevalence of Malignancy in Correlation to IBD Therapy and Disease Activity—A Retrospective Cohort Analysis over 5 Years
<b>Background/Objectives</b>: Patients with inflammatory bowel disease (IBD) are at an increased risk of various cancers; such as colorectal cancer; skin cancer; bile duct cancer; or lymphoma; with IBD itself not being the sole cause. Inappropriate or ineffective IBD therapy with a conti...
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2025-06-01
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| author | Agnieszka Jowita Kafel Anna Muzalyova Elisabeth Schnoy |
| author_facet | Agnieszka Jowita Kafel Anna Muzalyova Elisabeth Schnoy |
| author_sort | Agnieszka Jowita Kafel |
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| description | <b>Background/Objectives</b>: Patients with inflammatory bowel disease (IBD) are at an increased risk of various cancers; such as colorectal cancer; skin cancer; bile duct cancer; or lymphoma; with IBD itself not being the sole cause. Inappropriate or ineffective IBD therapy with a continuous inflammatory burden within the gut leads to an increased risk of malignancy. Our study aimed to investigate the risk of malignancy in our patient cohort; focusing on concomitant therapy; disease duration; and inflammatory burden. <b>Methods</b>: A total of 333 consecutive adult patients with IBD (Crohn’s disease; ulcerative colitis; and IBD unclassified) were included in this study. Data from patients were collected retrospectively using patient charts. The patients were treated in the gastroenterological outpatient clinic of the University Hospital of Augsburg; Germany; between 1 January 2014 and 31 December 2018. <b>Results</b>: The study group included 333 patients; 32 (9.61%) of whom suffered from malignancy (any form). Men (<i>n</i> = 21; 65.62%) tended to develop malignancy more often than women (<i>n</i> = 11; 34.38%, <i>p</i> = 0.051). It was also observed that the probability of developing cancer was 2.40 times higher in male patients than in female patients in our cohort. However, this trend was non-significant (HR = 2.412; <i>p</i> = 0.075). Furthermore; the probability of developing cancer increased with the increasing age at the time of the first diagnosis of IBD (HR = 1.088; <i>p</i> < 0.025). A total of 20 patients (6.00%) received their cancer diagnosis after being diagnosed with IBD. The majority of those patients had skin (<i>n</i> = 6; 30.00%) or colon cancer (<i>n</i> = 5; 25.00%). Other diseases such as CML; NHL; HL; HCC; liver sarcoma; prostate cancer; breast cancer; seminoma; thyroid cancer (a second cancer in one of the patients); or CUP syndrome/lung cancer were diagnosed in single patients. Patients with IBD and colon cancer (<i>n</i> = 5; 25.00%) shared some of the known risk factors for tumour development; such as a long-lasting IBD (<i>n</i> = 5; 100.00%), diagnosis at a young age (under 30; <i>n</i> = 3; 60.00%), and the coexistence of PSC (<i>n</i> = 1; 20.00%). The cancer prevalence rate was relatively low in our cohort despite the use of diverse biologics and immunosuppressive drugs. Faecal calprotectin was confirmed as a relevant tool for inflammation monitoring in this cohort. <b>Conclusions</b>: In our study cohort; we could show a low prevalence rate of malignancy in IBD. There were more malignancies in men and in patients who were diagnosed with IBD at later ages. It can be observed that the prevalence rate of cancer was relatively low despite the use of diverse biologics and immunosuppressive drugs; which is the major conclusion of this study. Additionally; the known correlation between elevated levels of faecal calprotectin and gut inflammation was confirmed through our statistical analysis. The use of calprotectin as a non-invasive screening tool for gut inflammation is advised. |
| format | Article |
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| institution | Kabale University |
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| language | English |
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| spelling | doaj-art-39a8a04ce44f45a1a1019c368fcb96f32025-08-20T03:27:00ZengMDPI AGBiomedicines2227-90592025-06-01136139510.3390/biomedicines13061395Malignancy and Inflammatory Bowel Disease (IBD): Incidence and Prevalence of Malignancy in Correlation to IBD Therapy and Disease Activity—A Retrospective Cohort Analysis over 5 YearsAgnieszka Jowita Kafel0Anna Muzalyova1Elisabeth Schnoy2Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, GermanyInternal Medicine III, University Hospital Augsburg, 86156 Augsburg, GermanyInternal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany<b>Background/Objectives</b>: Patients with inflammatory bowel disease (IBD) are at an increased risk of various cancers; such as colorectal cancer; skin cancer; bile duct cancer; or lymphoma; with IBD itself not being the sole cause. Inappropriate or ineffective IBD therapy with a continuous inflammatory burden within the gut leads to an increased risk of malignancy. Our study aimed to investigate the risk of malignancy in our patient cohort; focusing on concomitant therapy; disease duration; and inflammatory burden. <b>Methods</b>: A total of 333 consecutive adult patients with IBD (Crohn’s disease; ulcerative colitis; and IBD unclassified) were included in this study. Data from patients were collected retrospectively using patient charts. The patients were treated in the gastroenterological outpatient clinic of the University Hospital of Augsburg; Germany; between 1 January 2014 and 31 December 2018. <b>Results</b>: The study group included 333 patients; 32 (9.61%) of whom suffered from malignancy (any form). Men (<i>n</i> = 21; 65.62%) tended to develop malignancy more often than women (<i>n</i> = 11; 34.38%, <i>p</i> = 0.051). It was also observed that the probability of developing cancer was 2.40 times higher in male patients than in female patients in our cohort. However, this trend was non-significant (HR = 2.412; <i>p</i> = 0.075). Furthermore; the probability of developing cancer increased with the increasing age at the time of the first diagnosis of IBD (HR = 1.088; <i>p</i> < 0.025). A total of 20 patients (6.00%) received their cancer diagnosis after being diagnosed with IBD. The majority of those patients had skin (<i>n</i> = 6; 30.00%) or colon cancer (<i>n</i> = 5; 25.00%). Other diseases such as CML; NHL; HL; HCC; liver sarcoma; prostate cancer; breast cancer; seminoma; thyroid cancer (a second cancer in one of the patients); or CUP syndrome/lung cancer were diagnosed in single patients. Patients with IBD and colon cancer (<i>n</i> = 5; 25.00%) shared some of the known risk factors for tumour development; such as a long-lasting IBD (<i>n</i> = 5; 100.00%), diagnosis at a young age (under 30; <i>n</i> = 3; 60.00%), and the coexistence of PSC (<i>n</i> = 1; 20.00%). The cancer prevalence rate was relatively low in our cohort despite the use of diverse biologics and immunosuppressive drugs. Faecal calprotectin was confirmed as a relevant tool for inflammation monitoring in this cohort. <b>Conclusions</b>: In our study cohort; we could show a low prevalence rate of malignancy in IBD. There were more malignancies in men and in patients who were diagnosed with IBD at later ages. It can be observed that the prevalence rate of cancer was relatively low despite the use of diverse biologics and immunosuppressive drugs; which is the major conclusion of this study. Additionally; the known correlation between elevated levels of faecal calprotectin and gut inflammation was confirmed through our statistical analysis. The use of calprotectin as a non-invasive screening tool for gut inflammation is advised.https://www.mdpi.com/2227-9059/13/6/1395inflammatory bowel diseasecancerCrohn’s diseaseulcerative colitis: inflammatory bowel disease unclassifiedbiologicsimmunosuppressive drug |
| spellingShingle | Agnieszka Jowita Kafel Anna Muzalyova Elisabeth Schnoy Malignancy and Inflammatory Bowel Disease (IBD): Incidence and Prevalence of Malignancy in Correlation to IBD Therapy and Disease Activity—A Retrospective Cohort Analysis over 5 Years Biomedicines inflammatory bowel disease cancer Crohn’s disease ulcerative colitis: inflammatory bowel disease unclassified biologics immunosuppressive drug |
| title | Malignancy and Inflammatory Bowel Disease (IBD): Incidence and Prevalence of Malignancy in Correlation to IBD Therapy and Disease Activity—A Retrospective Cohort Analysis over 5 Years |
| title_full | Malignancy and Inflammatory Bowel Disease (IBD): Incidence and Prevalence of Malignancy in Correlation to IBD Therapy and Disease Activity—A Retrospective Cohort Analysis over 5 Years |
| title_fullStr | Malignancy and Inflammatory Bowel Disease (IBD): Incidence and Prevalence of Malignancy in Correlation to IBD Therapy and Disease Activity—A Retrospective Cohort Analysis over 5 Years |
| title_full_unstemmed | Malignancy and Inflammatory Bowel Disease (IBD): Incidence and Prevalence of Malignancy in Correlation to IBD Therapy and Disease Activity—A Retrospective Cohort Analysis over 5 Years |
| title_short | Malignancy and Inflammatory Bowel Disease (IBD): Incidence and Prevalence of Malignancy in Correlation to IBD Therapy and Disease Activity—A Retrospective Cohort Analysis over 5 Years |
| title_sort | malignancy and inflammatory bowel disease ibd incidence and prevalence of malignancy in correlation to ibd therapy and disease activity a retrospective cohort analysis over 5 years |
| topic | inflammatory bowel disease cancer Crohn’s disease ulcerative colitis: inflammatory bowel disease unclassified biologics immunosuppressive drug |
| url | https://www.mdpi.com/2227-9059/13/6/1395 |
| work_keys_str_mv | AT agnieszkajowitakafel malignancyandinflammatoryboweldiseaseibdincidenceandprevalenceofmalignancyincorrelationtoibdtherapyanddiseaseactivityaretrospectivecohortanalysisover5years AT annamuzalyova malignancyandinflammatoryboweldiseaseibdincidenceandprevalenceofmalignancyincorrelationtoibdtherapyanddiseaseactivityaretrospectivecohortanalysisover5years AT elisabethschnoy malignancyandinflammatoryboweldiseaseibdincidenceandprevalenceofmalignancyincorrelationtoibdtherapyanddiseaseactivityaretrospectivecohortanalysisover5years |