Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), increase the risk of malignancies, particularly colorectal cancer (CRC). We aimed to assess the incidence of malignancies in IBD patients managed using a treat-to-target approach and recommended surveillance. We retrospectively searched the electronic databases of two tertiary IBD centers in Milan from 2010 to 2019 for new diagnoses of malignancy in patients with pre-existing IBD. A total of 5239 patients with a follow-up of 19,820 years were included. In total, 71 malignancies were diagnosed in 70 patients (38 CD, 32 UC) with a mean age of 52.9 years, of whom 64% were former or active smokers. The annual incidence of all malignancies was 358 per 100,000 patient years (95% CI 275–444), and the standardized incidence rate (SIR) was 0.93 (95% CI 0.73–1.16). Gastrointestinal cancers were the most frequent (n= 17, 23.9%), in particular, CRC (n= 9), with an incidence of 45 per 100,000 (95% CI 15–74) and an SIR of 1.18 (95% CI 0.54–2.09). CRC occurred mainly in UC patients (6/8), while small bowel cancer was seen in CD patients (5/9). Melanoma and breast cancer (n= 8 each) were the most common non-GI cancers. No significant difference in incidence was found between CD or UC. Death occurred in nine patients (11%) and was due to cancer in eight of these cases, two of which were IBD-related. Most malignancies included in the surveillance were diagnosed at early (I–II) stages (20 vs. 4,p< 0.05). In patients with IBD, treat-to-target and strict surveillance were associated with a low incidence of cancer, similar to that of the general population, and the detection of malignancies at an early stage.
炎症性肠病（IBD），包括溃疡性结肠炎（UC）和克罗恩病（CD），会增加恶性肿瘤的风险，尤其是结直肠癌（CRC）。本研究旨在评估采用达标治疗策略并遵循推荐监测方案的IBD患者的恶性肿瘤发病率。我们回顾性检索了米兰两家三级IBD中心2010年至2019年的电子数据库，筛选出既往确诊IBD后新诊断恶性肿瘤的病例。共纳入5239例患者，总随访时间为19,820人年。在70例患者（38例CD，32例UC）中共诊断出71例恶性肿瘤，患者平均年龄52.9岁，其中64%有吸烟史（包括既往和当前吸烟者）。所有恶性肿瘤的年发病率为每10万人年358例（95% CI 275–444），标准化发病率（SIR）为0.93（95% CI 0.73–1.16）。胃肠道癌症最为常见（n=17，23.9%），其中结直肠癌（n=9）发病率为每10万人年45例（95% CI 15–74），SIR为1.18（95% CI 0.54–2.09）。结直肠癌主要发生于UC患者（6/8），而小肠癌多见于CD患者（5/9）。黑色素瘤和乳腺癌（各n=8）是最常见的非胃肠道癌症。CD与UC患者的发病率无显著差异。共有9例患者死亡（11%），其中8例死因为癌症，2例与IBD相关。纳入监测范围的大多数恶性肿瘤在早期（I–II期）即被诊断（20例 vs. 4例，p<0.05）。在IBD患者中，达标治疗和严格监测与较低的癌症发病率相关（与普通人群相似），并能实现恶性肿瘤的早期发现。
肿瘤(癌症)患者之家