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Intestinal and extraintestinal neoplasia in patients with inflammatory bowel disease in a tertiary care hospital.

CONTEXT
The development of neoplasia is an important concern associated with inflammatory bowel disease (IBD), especially colorectal cancer (CRC).


OBJECTIVES
Our aim was to determine the incidence of intestinal and extraintestinal neoplasias among patients with inflammatory bowel disease.


METHODS
There were retrieved information from 1607 patients regarding demographics, disease duration and extent, temporal relationship between IBD diagnosis and neoplasia, clinical outcomes and risk factors for neoplasia.


RESULTS
Crohn's disease (CD) was more frequent among women (P=0.0018). The incidence of neoplasia was higher in ulcerative colitis (UC) when compared to CD (P=0.0003). Eight (0.99%) patients developed neoplasia among 804 with CD: 4 colorectal cancer, 2 lymphomas, 1 appendix carcinoid and 1 breast cancer. Thirty (3.7%) patients developed neoplasia among the 803 UC: 13 CRC, 2 lymphomas and 15 extraintestinal tumors. While CRC incidence was not different among UC and CD (1.7% vs 0.5%; P=0.2953), the incidence of extraintestinal neoplasias was higher among UC (2.1% vs 0.5%, P=0.0009). Ten (26.3%) patients out of 38 with neoplasia died.


CONCLUSIONS
CRC incidence was low and similar in both diseases. There was a higher incidence of extraintestinal neoplasia in UC when compared to CD. Neoplasias in IBD developed at a younger age than expected for the general population. Mortality associated with malignancy is significant, affecting 1/4 of the patients with neoplasia.