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The Complex Interplay Between Inflammatory Bowel Disease and Malignancy

  • Inflammatory Bowel Disease (M Regueiro, Section Editor)
  • Published:
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Abstract

Purpose of Review

Both the chronic inflammation in inflammatory bowel disease (IBD), and its treatment, can increase the risk of malignancy. There is also an increasing number of patients with current and prior cancer who require IBD treatment. Thus, there is a complex interplay between immunosuppressive treatment and monitoring for new and recurrent cancer.

Recent Findings

Vedolizumab and ustekinumab have not been shown to increase the risk of malignancy. Transplant data shows a potential risk with tofacitinib although rheumatoid arthritis data does not. IBD patients have been shown to tolerate chemotherapy, specifically with cytotoxic compared with hormonal chemotherapy. Patients with prior cancer are at increased risk of new or recurrent cancers; however, immunosuppression appears to be safe.

Summary

Emerging treatments for IBD have demonstrated acceptable safety profiles for malignancy risk, and immunosuppression appears to be safe for use in patients with current and prior malignancy. More data is still needed to assess long-term risk of malignancy in these patients, especially with newer treatments.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, New York University School of Medicine, New York, NY, USA

    Jessica Kimmel

  2. Division of Gastroenterology, Department of Medicine, Inflammatory Bowel Disease Center at New York University Langone Health, New York University School of Medicine, New York, NY, USA

    Jordan Axelrad

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  1. Jessica Kimmel
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Correspondence to Jessica Kimmel.

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Kimmel, J., Axelrad, J. The Complex Interplay Between Inflammatory Bowel Disease and Malignancy. Curr Gastroenterol Rep 22, 13 (2020). https://doi.org/10.1007/s11894-020-0747-9

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