Risk of cancer, with special reference to extra-intestinal malignancies, in patients with inflammatory bowel disease

Table 1 Clinical features of the total studied inflammatory bowel disease patients n (%)

Clinical features	Value
Age (yr, mean ± SD)	43.4 ± 13.8
Gender
Female	305 (51.70)
Male	285 (48.3)
Type of IBD
CD	313 (53.05)
UC	256 (43.39)
IBDU	21 (3.56)
Disease extension (UC)1
Proctitis	61 (23.83)
Left-sided colitis	124 (48.44)
Pancolitis	71 (27.82)
Age at diagnosis (CD)1
A1 < 17	24 (7.67)
A2 17-40	208 (66.45)
A3 > 40	81 (25.88)
Disease location (CD)1
L1 ileal	112 (35.78)
L2 colic	76 (24.28)
L3 ileocolic	111 (35.46)
L4 upper gastrointestinal tract	6 (1.92)
L1 + L4	5 (1.60)
L3 + L4	3 (0.96)
Behaviour (CD)1
B1 non-stricturing non-penetrating	179 (57.19)
B2 stricturing	30 (9.58)
B3 penetrating	41 (13.10)
B1 + perianal disease	51 (16.29)
B2 + perianal disease	1 (0.32)
B3 + perianal disease	11 (3.52)
Immunosuppressive or biological treatment
Thiopurines	259 (43.90)
Anti-TNF-α drugs	84 (14.23)

¹In accordance with the Montreal classification. IBD: Inflammatory bowel disease; IBDU: Inflammatory bowel disease type unclassified; CD: Crohn's disease; UC: Ulcerative colitis.

Table 2 Clinical features of the cohort of patients with inflammatory bowel disease and cancer diagnosis n (%)

Features	Value
Disease extension (UC)1
Proctitis	1 (11.1)
Left-sided colitis	4 (44.45)
Pancolitis	4 (44.45)
Age at diagnosis (CD)1
A2 17-40	8 (88.89)
A3 > 40	1 (11.11)
Disease location (CD)1
L1 ileal	4 (44.45)
L2 colic	2 (22.22)
L3 ileocolic	2 (22.22)
L3 + L4 upper gastrointestinal tract	1 (11.11)
Behaviour (CD)1
B1 non-stricturing non-penetrating	7 (77.78)
B2 stricturing	1 (11.11)
B1 + perianal disease	1 (11.11)
Treatment at time of cancer diagnosis
Aminosalicylates	10 (55.56)
Thiopurines	6 (33.34)
Anti-TNF-α drugs	1 (5.55)
Nonspecific inflammatory bowel disease treatment	1 (5.55)
Immunosuppressive or biological treatment previous cancer diagnosis
Thiopurines	1 (5.55)
Anti-TNF-α drugs	1 (5.55)

¹In accordance with the Montreal classification. CD: Crohn's disease; UC: Ulcerative colitis; TNF-α: Tumor necrosis factor α.

Table 3 Specific cancers diagnosed in the cohort of patients with inflammatory bowel disease between 2005 and 2011

Location	n	Histological type
Urinary bladder	4	Urothelial carcinoma
Breast	3	Carcinoma
Skin	1	Melanoma
	2	Basal cell carcinoma
Appendix	2	Mucinous cystadenoma
Stomach	1	Adenocarcinoma
Pancreas	1	Adenocarcinoma
Lung	1	Adenocarcinoma
Liver	1	Hepatocellular carcinoma
Small intestine	1	Neuroendocrine carcinoma
Rectum	1	Carcinoid

Table 4 Cumulative incidences in both the inflammatory bowel disease cohort and the non-inflammatory bowel disease cohort and relative risk for different types of cancer

Cancer site	Cumulativeincidencein IBDcohort	Cumulative incidence inlocal population	RR	95%CI
Urinary bladder	0.68	0.13	5.23	1.95-13.87a
Breast	0.51	0.26	1.95	0.63-5.87
Melanoma	0.17	0.06	2.56	0.34-17.63
Basal cell carcinoma	0.33	1.26	0.26	0.06-1.00
Appendix	0.33	0.009	36.6	7.92-138.4a
Stomach	0.17	0.06	2.83	0.41-20.9
Pancreas	0.17	0.028	6.07	0.84-40.4
Lung	0.17	0.067	2.54	0.34-17.6
Liver	0.17	0.037	4.59	0.64-32.5
Small intestine	0.17	0.013	13.1	1.82-29.7a
Rectum	0.17	0.019	8.94	1.18-59.7a

^aP < 0.05. IBD: Inflammatory bowel disease.