Extraintestinal Cancers in Inflammatory Bowel Disease: A Literature Review

CANCERS(2023)

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Abstract
Simple Summary Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases that affect the gut and extraintestinal organs. Preliminary evidence has shown that patients with CD or UC are at increased risk of developing intestinal and extraintestinal cancers, therefore, there is an ever-growing concern about the safety of immunomodulators and biologics for these patients. The aim of this review is to summarize the evidence regarding the association between Inflammatory Bowel Disease (IBD) and extraintestinal cancers, and the safety and management of immunomodulators and biologics for patients with IBD and previous or current extraintestinal cancer. Background: Inflammatory bowel disease (IBD) is a group of chronic multifactorial inflammatory disorders including two major entities: Crohn's disease (CD) and ulcerative colitis (UC). Preliminary evidence suggests that patients with IBD may be at increased risk of developing intestinal and extraintestinal cancers (EICs). Actually, little is known about the association between IBD and EICs, and there is ever-growing concern regarding the safety of immunomodulators and biological therapy, which may represent a risk factor for carcinogenesis. Aims: The aim of this review is to summarize the evidence regarding the association between IBD and EICs, the safety of immunomodulators and biological therapy and the management of immunomodulators and biologic agents in IBD patients with prior or current EICs. Results: IBD patients have a higher risk of developing different forms of extraintestinal solid organ tumors and hematological malignancies. Immunomodulators and biological therapy may increase the risk of developing some types of EICs and may be consciously used in patients with IBD and current or prior history of malignancy. Conclusions: Decisions regarding the use of immunomodulators or biological therapies should be made on an individual basis, considering a multidisciplinary approach involving oncologists.
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Key words
inflammatory bowel disease,malignancy,extraintestinal cancers,biologic agents
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