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Related Experiment Videos

Extraintestinal cancers in inflammatory bowel disease.

A J Greenstein, R Gennuso, D B Sachar

    Cancer
    |December 15, 1985
    PubMed
    Summary

    Patients with inflammatory bowel disease (IBD) showed no overall increase in extraintestinal cancers. However, specific cancers like leukemia, lymphoma, and squamous cell cancers of the perianal and vaginal regions occurred more frequently than expected.

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    Area of Science:

    • Gastroenterology
    • Oncology
    • Epidemiology

    Background:

    • Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), affects a significant patient population.
    • The potential link between IBD and the development of extraintestinal malignant neoplasms requires thorough investigation.

    Purpose of the Study:

    • To investigate the incidence of extraintestinal malignant neoplasms in patients diagnosed with inflammatory bowel disease (IBD).
    • To compare observed cancer rates in IBD patients against expected rates in a standard population.

    Main Methods:

    • Retrospective analysis of case histories from 1961 IBD patients (1227 CD, 734 UC).
    • Calculation of observed (O) versus expected (E) cancer ratios using age- and sex-matched incidence figures.

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  • Stratification of cancers by type and location, including reticuloendothelial and squamous cell neoplasms.

    • Main Results:

    • No statistically significant increase in overall extraintestinal cancer O/E ratios for CD (0.76) or UC (1.32).
    • Significant excesses observed for leukemias in UC (P < 0.005) and lymphomas in both UC and CD (P < 0.005).
    • Marked excess of squamous cell cancers in the perianal region (30x expected) and vaginal cancers.

    Conclusions:

    • While overall extraintestinal cancer risk is not elevated in IBD, specific malignancies like leukemia, lymphoma, and squamous cell cancers show increased incidence.
    • Potential contributing factors include immunologic deficiencies, immunosuppressive medications, and possibly radiation exposure.
    • Chronic inflammation and immune suppression may play a role in the development of perianal and vaginal squamous cell cancers.