{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T07:09:28Z","timestamp":1790406568833,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T00:00:00Z","timestamp":1563494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In a 6-year, multicenter, prospective nested case\u2013control study, we aimed to evaluate risk factors for incident cancer in inflammatory bowel disease (IBD), when considering clinical characteristics of IBD and immunomodulator use. The secondary end point was to provide characterization of incident cancer types.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All incident cases of cancer occurring in IBD patients from December 2011\u20132017 were prospectively recorded in 16 Italian Group for the Study of Inflammatory Bowel Disease units. Each of the IBD patients with a new diagnosis of cancer was matched with 2 IBD patients without cancer, according to IBD phenotype (ulcerative colitis [UC] vs Crohn\u2019s disease [CD]), age (\u00b15 years), sex. Risk factors were assessed by multivariate logistic regression analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Cancer occurred in 403 IBD patients: 204 CD (CD cases), 199 UC (UC cases). The study population included 1209 patients (403 IBD cases, 806 IBD controls). Cancer (n = 403) more frequently involved the digestive system (DS; 32%), followed by skin (14.9%), urinary tract (9.7%), lung (6.9%), genital tract (6.5%), breast (5.5%), thyroid (1.9%), lymphoma (2.7%, only in CD), adenocarcinoma of the small bowel (SBA; 3.9%, 15 CD, 1 pouch in UC), other cancers (15.9%). Among cancers of the DS, colorectal cancer (CRC) more frequently occurred in UC (29% vs 17%; P &lt; 0.005), whereas SBA more frequently occurred in CD (13% vs 6.3% P = 0.039). In CD, perforating (B3) vs non-stricturing non-perforating (B1) behavior represented the only risk factor for any cancer (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.33\u20134.11). In CD, risk factors for extracolonic cancer (ECC) were a B3 vs B1 and a stricturing (B2) vs B1 behavior (OR, 2.95; 95% CI, 1.62\u20135.43; OR, 1.79; 95% CI, 1.09\u20132.98). In UC, risk factors for ECC and for overall cancer were abdominal surgery for UC (OR, 4.63; 95% CI, 2.62\u20138.42; OR, 3.34; 95% CI, 1.88\u20135.92) and extensive vs distal UC (OR, 1.73; 95% CI, 1.10\u20132.75; OR, 1.99; 95% CI, 1.16\u20133.47). Another risk factor for ECC was left-sided vs distal UC (OR, 1.68; 95% CI, 1.00\u20132.86). Inflammatory bowel disease duration was a risk factor for skin and urinary tract cancers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Perforating CD, extensive UC, and abdominal surgery for UC were identified as risk factors for overall incident cancer and for ECC. The clinical characteristics associated with severe IBD may increase cancer risk.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izz155","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T15:40:05Z","timestamp":1563550805000},"source":"Crossref","is-referenced-by-count":20,"title":["Cancer Risk in Inflammatory Bowel Disease: A 6-Year Prospective Multicenter Nested Case\u2013Control IG-IBD Study"],"prefix":"10.1093","author":[{"given":"Livia","family":"Biancone","sequence":"first","affiliation":[{"name":"Department of Systems Medicine, GI Unit, Universit\u00e0 degli Studi di Roma \u201cTor Vergata\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Armuzzi","sequence":"additional","affiliation":[{"name":"IBD Unit, Presidio Columbus Fondazione Policlinico A. Gemelli IRCCS \u2013 Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Lia","family":"Scribano","sequence":"additional","affiliation":[{"name":"GI Unit, AO S. Camillo Forlanini, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Castiglione","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Federico II, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"D\u2019inc\u00e0","sequence":"additional","affiliation":[{"name":"IBD Unit, Gastroenterology, Azienda-Universit\u00e0 of Padova, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambrogio","family":"Orlando","sequence":"additional","affiliation":[{"name":"IBD Unit, \u201cVilla Sofia-Cervello\u201d Hospital, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Papi","sequence":"additional","affiliation":[{"name":"IBD Unit, S. Filippo Neri Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Daperno","sequence":"additional","affiliation":[{"name":"AO Ordine Mauriziano, SC Gastroenterologia, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Vecchi","sequence":"additional","affiliation":[{"name":"University of Milan, IRCCS Ca\u2019 Granda, Ospedale Maggiore Policlinico Foundation, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Riegler","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi della Campania Luigi Vanvitelli,\u201d Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Fries","sequence":"additional","affiliation":[{"name":"IBD Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Alvisi","sequence":"additional","affiliation":[{"name":"GI Unit, AUSL Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianmichele","family":"Meucci","sequence":"additional","affiliation":[{"name":"GI Unit, San Giuseppe Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Mocciaro","sequence":"additional","affiliation":[{"name":"GI and Endoscopy Unit, ARNAS Civico Di Cristina-Benfratelli, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Rogai","sequence":"additional","affiliation":[{"name":"AOU Careggi, Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Festa","sequence":"additional","affiliation":[{"name":"IBD Unit, S. Filippo Neri Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Guidi","sequence":"additional","affiliation":[{"name":"IBD Unit, Presidio Columbus Fondazione Policlinico A. Gemelli IRCCS \u2013 Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Testa","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Federico II, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Spina","sequence":"additional","affiliation":[{"name":"IRCCS Policlinico S. Donato, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Renna","sequence":"additional","affiliation":[{"name":"IBD Unit, \u201cVilla Sofia-Cervello\u201d Hospital, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Viola","sequence":"additional","affiliation":[{"name":"IBD Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Patturelli","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi della Campania Luigi Vanvitelli,\u201d Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Di Mitri","sequence":"additional","affiliation":[{"name":"GI and Endoscopy Unit, ARNAS Civico Di Cristina-Benfratelli, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Frankovic","sequence":"additional","affiliation":[{"name":"IBD Unit, Gastroenterology, Azienda-Universit\u00e0 of Padova, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Calabrese","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, GI Unit, Universit\u00e0 degli Studi di Roma \u201cTor Vergata\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelina","family":"Petruzziello","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, GI Unit, Universit\u00e0 degli Studi di Roma \u201cTor Vergata\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"De Cristofaro","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, GI Unit, Universit\u00e0 degli Studi di Roma \u201cTor Vergata\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Sena","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, GI Unit, Universit\u00e0 degli Studi di Roma \u201cTor Vergata\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Ruffa","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, GI Unit, Universit\u00e0 degli Studi di Roma \u201cTor Vergata\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetto","family":"Neri","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, GI Unit, Universit\u00e0 degli Studi di Roma \u201cTor Vergata\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, GI Unit, Universit\u00e0 degli Studi di Roma \u201cTor Vergata\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,7,19]]},"reference":[{"key":"2019091012331798300_CIT0001","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1056\/NEJMra1403718","article-title":"Cancers complicating inflammatory bowel disease","volume":"372","author":"Beaugerie","year":"2015","journal-title":"N Engl J Med."},{"key":"2019091012331798300_CIT0002","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1053\/j.gastro.2003.11.010","article-title":"Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis","volume":"126","author":"Rutter","year":"2004","journal-title":"Gastroenterology."},{"key":"2019091012331798300_CIT0003","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1093\/ecco-jcc\/jjv141","article-title":"European evidence-based consensus: inflammatory bowel disease and malignancies","volume":"9","author":"Annese","year":"2015","journal-title":"J Crohns Colitis."},{"key":"2019091012331798300_CIT0004","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1093\/ecco-jcc\/jjx008","article-title":"Third European evidence-based consensus on diagnosis and management of ulcerative colitis. 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