C0419 - Malignancies in Inflammatory Bowel Disease Patients – A Population-Based Study of the Last Two Decades

Maryam Haider, MD¹, Ali Al Sbihi, MD¹, Raseen Tariq, MD², Iana Gueorguieva, MD^3
1Wayne State University/Detroit Medical Center Sinai Grace Hospital, Detroit, MI; ²Mayo Clinic, Rochester, MN; ³Ascension Providence Hospital/Michigan State University College of Human Medicine, Southfield, MI

Introduction: Inflammatory Bowel Disease (IBD) is a chronic inflammatory disorder of the gut with prevalence estimated to be more than 3 million in the USA. Many studies suggest that IBD patients have an increased risk of developing intestinal and extraintestinal malignancies. It is suspected, IBD-related inflammation and carcinogenic properties of immunosuppressive drugs are main culprits of initiation and progression of tumor formation. This study aimed to analyze the nationwide prevalence of malignant neoplasms in IBD patients.

Methods: NIS database was queried from January 2000 to December 2019 to retrieve records of patients admitted with a principal or secondary diagnosis of IBD. We compared the incidence of malignant neoplasms in IBD (cases) based on ICD codes to patients who did not have IBD (controls). Controls were 1:1 fixed ratio nearest neighbor (greedy) propensity score-matched using the patient’s age, sex, and race. We performed univariate logistic regression to calculate the odds ratio. Statistical analysis is performed in R (Studio 1.4). The p-values of < 0.01 were considered to be significant.

Results: A total of 1,109,008 records were identified with IBD. IBD patients have increased risk of some cancers including small intestine (OR, 4.40; 99% CI, 3.69 – 5.25; p < 0.001), bile duct (OR, 3.97; 99% CI, 3.32 – 4.74; p < 0.001), myelodysplastic syndrome (OR, 1.66; 99% CI, 1.52 – 1.81; p < 0.001, anorectal (OR, 1.64; 99% CI, 1.55 – 1.73; p < 0.001), skin (OR, 1.62; 99% CI, 1.57 – 1.68; p < 0.001), colorectal (OR, 1.29; 99% CI, 1.25 – 1.33; p < 0.001), urinary (OR, 1.09; 99% CI, 1.05 – 1.13; p < 0.001),and prostate (OR, 1.13; 99% CI, 1.10 – 1.17; p < 0.001). IBD patients are at low risk of head and neck, esophagus, stomach, respiratory, bone, breast, nervous system, myeloma, ovary, testis, and pancreas (table1).

Discussion: IBD and malignancies have been discussed in the past. Despite these efforts, much remains unknown regarding the increased risk of cancers in IBD. Our results showed that IBD patients are at an increased risk of certain neoplasms, specifically small bowel, bile duct, and myelodysplastic syndrome. Although inflammatory injury and immunosuppression can play a role in carcinogenesis, we still know little about the risk factors contributing to neoplasms. Therefore, more studies are needed to determine the risk factor and mechanism for developing malignancies in IBD patients. It is essential to emphasize age-appropriate cancer screening in our IBD patients.



Disclosures:


Maryam Haider, MD¹, Ali Al Sbihi, MD¹, Raseen Tariq, MD², Iana Gueorguieva, MD³. C0419 - Malignancies in Inflammatory Bowel Disease Patients – A Population-Based Study of the Last Two Decades, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.