P534 IBD-related malignancies observed in 2015–2018: 4 years’ results from the prospective nationwide Hungarian registry
A. Milassin*1, M. Rutka1, K. Farkas1, A. Bálint1, R. Bor1, A. Fábián1, Z. Szepes1, T. Szamosi2, K. Szántó1, P. Miheller3, Z. Barta4, J. Banai2, Á. Kovács5, Á. Salamon6, L. Lakatos7, L. Lakner7, K. Palatka8, M. Papp9, E. Schafer2, J. Novák10, Z. Erdélyi11, Z. Kürti12, P. L. Lakatos12, P. Sarlós13, N. Szigeti14, G. Veres9, A. Zaránd16, A. Gelley17, Á. Vincze18, F. Nagy1, T. Molnár1
1University of Szeged, First Department of Internal Medicine, Szeged, Hungary, 2Military Hospital - State Health Centre, Budapest, Hungary, 3Semmelweis University, Second Department of Internal Medicine, Budapest, Hungary, 4University of Debrecen, Department of Gastroenterology, Department of Medicine, Clinical Centre, Debrecen, Hungary, 5Péterfi Sándor Utcai Hospital Centre, Budapest, Hungary, 6Tolna County Teaching Hospital, Department of Gastroenterology, Szekszárd, Hungary, 7Markusovszky Hospital, Department of Medicine and Gastroenterology, Szombathely, Hungary, 8University of Debrecen, Institute of Medicine, Department of Gastroenterology, Debrecen, Hungary, 9University of Debrecen, Division of Gastroenterology, Department of Internal Medicine, Debrecen, Hungary, 10Pándy Kálmán Hospital of Békés County, Gyula, Hungary, 11Department of Medicine, Csolnoky F. Province Hospital, Veszprém, Hungary, 12Semmelweis University, First Department of Internal Medicine, Budapest, Hungary, 13Unversity of Pécs, Division of Gastroenterology, First Department of Medicine, Pécs, Hungary, 14University of Pécs, Second Department of Internal Medicine, Pécs, Hungary, 16Semmelweis University, First Deparment of Surgery, Budapest, Hungary, 17Buda Hospital of the Hospitaller Order of Saint John of God, Budapest, Hungary, 18University of Pécs, First Department of Internal Medicine, Pécs, Hungary
Background
Inflammatory bowel diseases (IBD – Crohn’s disease (CD); ulcerative colitis (UC)) are associated with an increased risk of colorectal cancer (CRC). Other extraintestinal malignancies have shown variable incidence rates.
Methods
The aim of our nationwide registry was to prospectively collect IBD-related malignancies diagnosed in the Hungarian IBD population. Data on all malignancies developed between January 2015 and November 2018 in IBD patients were recorded. Each members of the Hungarian Society of Gastroenterology were prospectively interviewed three monthly by personal emails to report malignancies observed in their patient population. Demographic and clinical data including adherence, tumour stage, previous immunosuppressive and biological therapy were also collected.
Results
106 newly diagnosed malignancies were reported. Half of the cancers were colorectal cancers. Mean disease duration at the time of the diagnosis of CRC was 18.7 (1–43) years, mean age was 52.4 (33–87) years. 69.8% of the CRC cases were associated with UC, 51% with pancolitis, 24% with left-sided colitis. From the CD’s patients the ileocolonic and colonic localisation were observed in 41.6% and 50% of the patients, respectively. According to our results CRC was more common in male patients (66%). The most common CRC localisation was the rectosigmoidal part of the colon (58.5%). Only 1/3 of the CRC’s cases were diagnosed in early stage. 20.1% of the patients died during the observation period. Other frequent malignancies were haematological malignancies (7.5%), lung cancer (6.6%), non-melanotic skin cancer (5.6%). The most common extraintestinal malignancies were non-melanotic skin cancer (14%), 80% of them were treated with biological therapy (immunosuppressive therapy: 20%, biological therapy and immunosuppressive therapy combination: 80%).
Conclusion
The most frequently observed IBD-related malignancy was colorectal cancer in our cohort, which mainly involved the distal part of the colon. CRC presented typically in male UC patients with pancolitis or left-sided colitis. The most common extraintestinal malignancies were non-melanotic skin cancer.