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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2021; 13(12): 1956-1980
Published online Dec 15, 2021. doi: 10.4251/wjgo.v13.i12.1956
Solid extraintestinal malignancies in patients with inflammatory bowel disease
Anastasia Mala, Kalliopi Foteinogiannopoulou, Ioannis E Koutroubakis
Anastasia Mala, Department of Medical Oncology, University Hospital of Heraklion, Heraklion 71110, Crete, Greece
Kalliopi Foteinogiannopoulou, Ioannis E Koutroubakis, Department of Gastroenterology, University Hospital of Heraklion, Heraklion 71110, Crete, Greece
Author contributions: Mala A, Foteinogiannopoulou K and Koutroubakis IE wrote the paper.
Conflict-of-interest statement: Mala A and Foteinogiannopoulou K have no conflict of interest. Koutroubakis IE is an Αdvisory board member for Abbvie, Astellas, Genesis, Janssen, MSD, Pharmacosmos, Pfizer, Shire and Takeda; Speaker for AbbVie, Astellas, Genesis, Janssen, MSD, Takeda and Mylan; research support Abbvie and Ferrin.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ioannis E Koutroubakis, MD, PhD, Professor, Department of Gastroenterology, University Hospital of Heraklion, Stavrakia-Voutes, PO BOX:1352, Heraklion 71110, Crete, Greece. ikoutroubakis@gmail.com
Received: April 9, 2021
Peer-review started: April 9, 2021
First decision: June 24, 2021
Revised: July 6, 2021
Accepted: August 13, 2021
Article in press: August 13, 2021
Published online: December 15, 2021
Processing time: 249 Days and 6.1 Hours
Abstract

Malignancies constitute the second cause of death in patients with inflammatory bowel diseases (IBD), after cardiovascular diseases. Although it has been postulated that IBD patients are at greater risk of colorectal cancer compared to the general population, lately there has been evidence supporting that this risk is diminishing over time as a result of better surveillance, while the incidence of extraintestinal cancers (EICs) is increasing. This could be attributed either to systemic inflammation caused by IBD or to long-lasting immunosuppression due to IBD treatments. It seems that the overall risk of EICs is higher for Crohn’s disease patients and it is mainly driven by skin cancers, and liver-biliary cancers in patients with IBD and primary sclerosing cholangitis. The aims of this review were first to evaluate the prevalence, characteristics, and risk factors of EICs in patients with IBD and second to raise awareness regarding a proper surveillance program resulting in early diagnosis, better prognosis and survival, especially in the era of new IBD treatments that are on the way.

Keywords: Extraintestinal malignancies; Crohn’s disease; Ulcerative colitis; Thiopurines; Anti-tumor necrosis factor

Core Tip: Patients with inflammatory bowel disease (IBD) are at risk of malignancies. The incidence of colorectal cancer is decreasing over time as a result of screening surveillance and better endoscopic techniques. Although IBD patients are not at high risk of overall extraintestinal malignancies compared to the general population, they have an increased risk of certain cancers. This should be kept in mind in the management of IBD patients especially in the context of immunosuppressive treatment that constitutes the cornerstone of treatment. Guidelines should incorporate all the preventive measures and be applied to everyday clinical practice for early diagnosis and better prognosis.