Incident Colorectal Cancer in Inflammatory Bowel Disease

Neri, Benedetto; Scribano, Maria Lia; Armuzzi, Alessandro; Castiglione, Fabiana; D’Incà, R.; Orlando, Ambrogio; Festa, Stefano; Riegler, G.; Fries, Walter; Meucci, Gianmichele; Alvisi, Patrizia; Mocciaro, Filippo; Papi, Claudio; Mossa, Michelangela; Sena, Giorgia; Guidi, L.; Testa, Anna; Renna, Sara; Frankovic, I.; Viola, Anna; Patturelli, Marta; Chiaramonte, Carlo; Biancone, Livia

doi:10.3390/cancers14030721

Cited by 6 publications

(5 citation statements)

References 42 publications

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“…This further supports the need for tailored surveillance programs aimed to prevent or allow a timely diagnosis of CRC, most often mimicking IBD-related symptoms. Accordingly, our previous multicenter study reported an overall low frequency of symptomatic CRC in IBD, thus also highlighting the issue of appropriate CRC surveillance in tertiary IBD referral centers [34].…”

Section: Discussionmentioning

confidence: 79%

Mucinous and Signet-Ring Cell Colonic Adenocarcinoma in Inflammatory Bowel Disease: A Case–Control Study

Neri

Mancone

Savino

et al. 2023

Cancers

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A higher frequency of mucinous and signet-ring cell colonic adenocarcinoma has been reported in inflammatory bowel disease (IBD). The primary aim was to investigate the frequency of mucinous and signet-ring cell colorectal adenocarcinoma in patients with IBD (Cases) versus age-matched non-IBD Controls. The secondary aims were to compare the characteristics of these two histotypes of colorectal cancer (CRC) in IBD patients vs. Controls and to search for specific risk factors in IBD. In a case–control study, all IBD patients with CRC diagnosed from 2000 to 2022 were enrolled and matched for age (1:2) with non-IBD Controls with CRC. The study population included 120 CRC patients (40 IBD, 80 Controls). In IBD, CRC included standard adenocarcinoma in 23 (57.5%) patients mucinous/signet-ring cell adenocarcinoma in 17 (42.5%) patients. The proportion of mucinous/signet-ring cell adenocarcinoma was higher in IBD than in Controls (17 [42.5%] vs. 18 [22.5%]; p = 0.03). In rectal CRC, the proportion of mucinous/signet-ring cell adenocarcinoma was higher than standard adenocarcinoma in IBD (8 [47.1%] vs. 4 [17.4%]; p = 0.04) but not in Controls (4 [22.2%] vs. 20 [32.2%]; p = 0.59). In rectal CRC, the proportion of these two histotypes was higher in Cases than in Controls (8/12 [66.6%] vs. 4/24 [16.6%]; p = 0.008), with no risk factors identified in IBD. CRC was more frequently represented by mucinous/signet-ring cell adenocarcinoma in IBD than in age-matched non-IBD Controls. In IBD, these two CRC histotypes were more frequent in the rectum.

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Section: Discussionmentioning

confidence: 79%

Mucinous and Signet-Ring Cell Colonic Adenocarcinoma in Inflammatory Bowel Disease: A Case–Control Study

Neri

Mancone

Savino

et al. 2023

Cancers

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“…Anti-TNFα agents, particularly ADA, followed by UST and VED, play a role in the onset of dermatological pathologies, including urticaria, erythema, and dermatitis [ 57 ]; moreover, our data showed a higher incidence of malignancies with VED when adjusted on 10 years of treatment. Chronic inflammation is more frequently related to colorectal cancer development and extraintestinal neoplasms in IBD patients than in the general population [ 58 , 59 ]. Nevertheless, immunosuppressive treatment, including biologics, exhibit carcinogenic properties [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety Profiles of Biological Therapies in Inflammatory Bowel Disease: Real Life Data from an Active Pharmacovigilance Project

et al. 2022

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Post-marketing surveillance is essential to evaluate the risk/benefit profile of drugs; however, pharmacovigilance studies comparing persistence and safety of biologic therapies in patients with inflammatory bowel disease (IBD) are scant. The aim of this study was to prospectively investigate persistence together with safety profiles of biologics in a cohort of patients diagnosed with Crohn’s Disease (CD) or ulcerative colitis (UC) followed by the IBD unit of Messina and treated with infliximab (IFX), adalimumab (ADA), golimumab (GOL), vedolizumab (VED), and ustekinumab (UST) from 2017 through 2021. Descriptive and treatment persistence analyses with predictors for discontinuation and occurrence of adverse drug reactions (ADRs) were performed. A total of 675 IBD patients were enrolled. A higher persistence rate was noted for UST and ADA in the first year (83.8% and 83.1%, respectively) and for IFX in the fifth year of treatment (58.1%). GOL, VED, and UST—all used as second/third-line therapies—seemed to have a higher risk of non-persistence than IFX (in order HR: 2.19; CI 95%: 1.33–3.61, 1.45; 1.04–2.04, 2.25; 1.25–4.07) as well as switchers and those who had at least one ADR (18.1; 13.22–24.68 and 1.55; 1.20–1.99, respectively). The reported ADRs, which were generally mild–moderate, were largely known. However, real-world data should be implemented to further study undetected safety concerns, including risk of malignancy.

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“…It is known that there is increased risk of intestinal cancer in CD patients 6,27 . A meta‐analysis, which was based on six Western population studies showed an increased risk of intestinal cancer in CD (SIR 1.9; 95% CI, 1.4–2.5) 28 .…”

Section: Temporal Trend Of CD Surgical Rate Indications and Methodsmentioning

confidence: 99%

“…26 It is known that there is increased risk of intestinal cancer in CD patients. 6,27 A meta-analysis, which was based on six Western population studies showed an increased risk of intestinal cancer in CD (SIR 1.9; 95% CI, 1.4-2.5). 28 In Asia, only a few population-based studies have examined the association between IBD and CRC development.…”

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confidence: 99%

Perioperative optimization of Crohn's disease

Lin

Chen

et al. 2022

Annals of Gastroent Surgery

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Crohn's disease (CD) is a chronic inflammatory disease mainly affecting the gastrointestinal tract. With the increased availability of modalities in the last two decades, the treatment of CD has advanced remarkably. Although medical treatment is the mainstay of therapy, most patients require surgery during the course of their illness, especially those who experience complications. Nutritional optimization and ERAS implementation are crucial for patients with CD who require surgical intervention to reduce postoperative complications. The increased surgical risk was found to be associated with the use of corticosteroids, but the association of surgical risk with immunomodulators, biologic therapy, such as anti‐TNF mediations, anti‐integrin medications, and anti‐IL 12/23 was low in certainty. Decisions about preoperative medication must be made on an individual case‐dependent basis. Preoperative imaging studies can assist in the planning of appropriate surgical strategies and approaches. However, patients must be informed of any alterations to their treatment. In summary, the management of perioperative medications and surgery‐related decision‐making should be individualized and patient‐centered based on a multidisciplinary approach.

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Incident Colorectal Cancer in Inflammatory Bowel Disease

Cited by 6 publications

References 42 publications

Mucinous and Signet-Ring Cell Colonic Adenocarcinoma in Inflammatory Bowel Disease: A Case–Control Study

Mucinous and Signet-Ring Cell Colonic Adenocarcinoma in Inflammatory Bowel Disease: A Case–Control Study

Effectiveness and Safety Profiles of Biological Therapies in Inflammatory Bowel Disease: Real Life Data from an Active Pharmacovigilance Project

Perioperative optimization of Crohn's disease

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