John Kisiel, M.D., discusses a recently published article in Gut about risk of cancer in patients with Crohn’s disease and ulcerative colitis and a previous history of cancer on immunosuppressive therapy.
Researchers know that patients on immunosuppressants do have an increased risk of developing cancer. This risk appears to be quite high in patients who have received a solid organ transplant. Researchers have also seen an increased risk in certain types of cancers like lymphomas and nonmelanoma skin cancers. Immunosuppressants are very effective for IBD, particularly when combined with Humira, Cimzia, and Remicade.
The aim of the study was to see if patients with a prior history of cancer were more like to develop new or recurrent cancers if treated with immunosuppressants. A group of about 700 gastroenterologist across the country of France enrolled all their patients into the study for a full year, which was nearly 20,000 patients. The sample included about 400 patients with a prior history of cancer. If patients had a prior history of cancer, they were twice as likely to develop a new cancer. Other risk factors for developing cancer include age. If patients were taking an immunosuppressant, they were not anymore likely to develop a new cancer. Patients with prior cancers treated with immunosuppressants appeared to have the same risk factor as patients with prior cancer history not taking immunosuppressants.
This is a very important finding and good news for patients. Patients with prior history of cancer can be treated aggressively for their ulcerative colitis or Crohn's disease using modern, combination immunosuppressant therapies.
If a patient has a history of melanoma or lymphoma skin cancer, there still should be caution about using immunosuppressants.
Read the full study online here.
For more information about IBD, visit mayoclinic.org/ibd.
Dr. Kisiel is a gastroenterologist at Mayo Clinic.