In previous studies, CD has been associated with increased small bowel cancer risk, but these studies were limited by multiple factors resulting in exaggerated relative risks and incidence data. Data on an association between ulcerative colitis (UC) and small bowel cancer are scarce. The Swedish-Danish cohort consisted of 161,896 patients diagnosed with IBD during 1969–2017 (CD, 47,370; UC, 97,515; unclassified IBD, 17,011) and matched reference individuals from the general population.
During follow-up, 237 cases of small bowel cancer were diagnosed in the IBD group (CD, 24.4/100,000 person-years; UC, 5.88/100,000 person-years), compared with 640 cases in reference individuals (CD reference group, 2.81/100,000 person-years; UC reference group, 3.32/100,000 person-years). This corresponds to one extra case of small bowel cancer in 385 CD patients, and one extra case in 500 UC patients, followed-up for 10 years. The adjusted hazard ratio for incident small bowel cancer was 9.09 (95% CI 7.34–11.3) and 1.85 (95% CI 1.43–2.39) in CD and UC patients, respectively. Relative risks among CD patients were highest for recently diagnosed, childhood-onset, ileal, and stricturing disease; among UC patients for those with extensive colitis and primary sclerosing cholangitis. In CD patients, the risk of all small bowel cancer subtypes was increased (aHR 15.8 for adenocarcinoma, 5.51 for neuroendocrine tumours, and 4.04 for sarcoma). In UC patients, only the risk of adenocarcinoma (aHR 1.99) and neuroendocrine tumours (aHR 2.01) were increased. The authors noted that further studies should evaluate the utility of small bowel cancer surveillance in selected populations.
- Axelrad J, et al. ECCO-IBD 2020, OP08.
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Table of Contents: ECCO 2020
Featured articles
Gut Microbiome as Treatment Target
Response to faecal microbiota transplantation in UC
Bioactives produced by gut bacteria to modulate immune response
Big Data Analysis
Multi-omics help describe CD phenotypes
The positive impact of genetic data on drug development
Experimental Therapies: Study Results
AMT-101: an oral human IL-10 fusion protein
Phase 2 results of first-in-class TL1A inhibitor
Open-label extension study of risankizumab: final results
Clinical remission after dose escalation of upadacitinib
Short- and Long-Term Treatment Results
Infliximab discontinuation increases relapse risk
Tofacitinib ‘real-world’ effectiveness in active UC
Subcutaneous ustekinumab as maintenance therapy in UC
Subcutaneous vedolizumab maintenance therapy in CD
Vedolizumab treatment persistence and safety
Specific Therapeutic Strategies
Impact of strategies on intestinal resection rate
Early ileocaecal resection in CD patients failing conventional treatment
Biologics before surgery in IBD do not elevate infection risk
Top-down infliximab superior to step-up in children with CD
High versus standard adalimumab in active UC
Head-to-Head Comparison of Treatments
Vedolizumab and anti-TNF therapies: a real-world comparison
Cancer Risk
Increased risk of small bowel cancer in IBD
Increased incidence of colorectal cancer and death in CD
Risk of rectal, anal cancer increased in perianal CD
Glyco-fingerprint as risk factor of UC-associated cancer
Miscellaneous Topics
Resolution of mucosal inflammation has dramatic effect
PICaSSO validated in real-life study
Re-inducing inflammation in organoids from UC patients
Role of immune cells in intestinal fibrosis
Association between meat consumption and IBD risk
CD exclusion diet corrects dysbiosis
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