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Risk of cancer under immunosuppressive therapy in patients with IBD and previous cancer

The latest issue of Gut evaluates the risk of new or recurrent cancer under immunosuppressive therapy in patients with IBD and previous cancer.

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Professor Laurent Beaugerie and colleagues from France explored the risk of new or recurrent cancer among patients with IBD and previous cancer, exposed or not to immunosuppressants.

Among the 17,047 patients of the CESAME prospective observational cohort who were enrolled from 2004 to 2005, and followed-up until 2007, the team identified 405 patients with cancer diagnosed previous to study entry.

The researchers calculated the rates of incident cancer in patients with or without previous cancer.

The team performed survival analysis and nested case-control study to assess the impact of immunosuppressants on the risk of incident new or recurrent cancer in patients with previous cancer.

The rate of incident cancer was 21 per 1000 patient-years, and 6 per 1000 patient-years in patients with and without previous cancer, respectively.

Rates of new cancers were,13 per 1000 patient-years in patients not taking immunosuppressants
Gut

The research team found that the multivariate-adjusted hazard ratio of incident cancer between patients with and without previous cancer was 1.9.

Among patients with previous cancer, the rates of new and recurrent cancers were, respectively, 13 per 1000 patient-years, and 6 per 1000 patient-years in the 312 patients who were not taking immunosuppressant at the time of study entry, and 23 per 1000 patient-years, and 4 per 1000 patient-years in the 93 patients treated with immunosuppressants at study entry.

The team observed no significant association between the exposure to immunosuppressants, and the risk of new or recurrent cancer.

Professor Beaugerie's team concludes, "Patients with IBD with a history of cancer are at increased risk of developing any cancer, with a predominant incidence of new cancers."

"Treatment with immunosuppressants has no overall major impact per se on this risk."

Gut 2014; 63: 1416-1423
12 August 2014

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