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Gastroenterology. 2011 Nov;141(5):1621-28.e1-5. doi: 10.1053/j.gastro.2011.06.050. Epub 2011 Jun 25.

Increased risk for nonmelanoma skin cancers in patients who receive thiopurines for inflammatory bowel disease.

Collaborators (680)

Colombel JF, Cosnes J, Gendre JP, Lémann M, Hébuterne X, Cortot A, Bouhnik Y, Laharie D, Dupas JL, Flourié B, Lerebours E, Beaugerie L, Peyrin-Biroulet L, Allez M, Messing B, Cadiot G, Soulé JC, Gornet JM, Veyrac M, Duclos B, Beau P, Bourreille A, Baumer P, Carbonnel F, Heresbach D, Metman EH, Florent C, Blain A, Faucheron JL, Potier P, Boehm C, Kurtz T, Lamouliatte H, Nion-Larmurier I, Delchier JC, Marie Weiss A, Pierre Cézard J, Siproudhis L, Nahon S, Sondag D, Jian R, Souquet JC, Bord P, Coffin B, D'Almagne H, Delasalle P, Fournier R, Cavicchi M, Souffran MH, Vandromme L, Guedon C, Seksik P, Michiels C, Renard P, Rogier P, Gouilloud S, Rotenberg A, Savoye G, Thevenin A, Mallet L, Brazier F, Jean F, Justum AM, Latrive JP, Gerbal JL, Pierrugues R, Chardonnal G, Picon L, Reix N, Uettwiller H, Courillon Mallet A, Palacci A, Bensaude RJ, Bonniaud P, Empinet O, Nisard A, Rudelli A, Tubiana B, Capelle P, Dabadie A, Evard D, Julien PE, Picon-Coste M, Schneider S, Goldfain D, Bellanger J, Blondelot JP, Lemière S, Mockly JF, Pellat B, Gatineau-Sailliant G, Nalet B, Nancey S, Kusielewicz D, Loison P, Popot JM, Merite F, Roux JP, Afchain P, Blanquart A, Heyries L, Reville M, Viron D, Zerbib F, Claviere C, Léostic D, Pouderoux P, Moitry A, Hagège H, Hugot J, Humeau B, Sabate JM, Lederman E, Lescut D, Luneau F, Mesnard B, Smadja L, Steinberg M, Brun M, Macaigne G, Marchal JL, Ollivier S, Ouvry D, Perche JP, Rambaud S, Benamouzig R, Cazenave JL, Coffin JC, Blazquez M, Lagneau M, Person B, Wittersheim C, Napoleon B, Cemachovic I, Iglicki F, Howaizi M, Leprince E, Leurent B, Morin T, Darsouni R, Attar A, Baron P, Breton A, Gillion JM, Guemene JM, Jouffre C, Moreau X, Claude P, Quinton A, Abitbol V, Brichard JM, Desaint B, Bouygues M, Chatrenet P, Salmeron M, Silvie J, Waldner B, Emery Y, Moraillon A, Kunkel D, Dubois P, Faure P, L'Hirondel C, Labérenne JE, Moreau P, Pereira A, Plihon G, Wolff T, Ngo Y, Boruchowicz A, Jost B, Gotlib JP, Danne O, Raoux P, Ramond-Bouhali MJ, Baetz A, Veyres B, Chapoutot C, Le Dréau G, Filippi J, Mudry J, Kalt P, Minault S, Bounin PA, Andréani T, Charneau J, Reijasse D, Bolze JL, Thaunat JL, Le Couteulx C, Maurage C, Bader R, Codjovi P, Migairou JL, Morali A, Rey P, Molard BR, Petit R, Koch S, Cassan P, Deschamps JP, Caby CM, Meurisse JJ, Boulant J, Diacono M, Monsch JM, Bellaiche G, Guegan M, Comte JM, Cayla JM, Tallec FL, Meurisse F, Desurmont P, Roget L, Bouyssou P, Le Gall B, Bloch F, Larvol L, Jullien M, Moreau J, Rebouissoux L, Decroix B, Dib N, Dieterling P, Lenormand F, Lagier E, Fallourd P, Charpin S, Bertrand H, Bommelaer G, Battistelli D, Delon B, Dentant L, Dorval E, Dumortier J, Gaye-Bareyt E, Gerosa Y, Guez C, Mornet M, Benfredj P, Piperaud R, Stremsdoerfer N, Verdier E, Grinholtz A, Barjonet G, See A, Arotçarena R, Baudet A, Broyer J, Charachon A, Blondon H, Mouton P, Claudez H, Labat-Labourdette J, Haëm J, Estable P, Levy P, Rosenbaum A, Balavoine Y, Blanchi A, Coutarel P, Delaperriere N, Dervichian M, Marois F, Seroka J, Michaud L, Leroy O, Meyran E, Poilroux B, Tensaouti A, Paupard T, Agard D, Beaulieu S, Benfiguig K, Capony P, Cottereau J, Desreumaux P, Duché M, Mamou P, Etienney I, D'Abrigeon G, Godeberge B, Tucat G, Puech J, Roger J, Lapalus MG, Bauret P, Houcke P, Pornin B, Champigneulle B, Cuissard L, David XR, Lombard F, Granveau A, Hamon JF, Ink O, Namias A, Pillon D, Reignier A, Tordjman G, Christidis C, Zirabe S, Audebert M, Bion E, Bourgeaux C, Poupardin C, Deplaix P, Fratini G, Garnier T, Desseaux G, Magois H, Lochum S, Vergier JF, Texereau P, Rat C, Uzzan F, Vidal A, Vinante N, Watrin B, Wurtz-Huckert C, Barre B, Chaslin D, Contou JF, Coupier D, David B, Gargot D, Huc D, Barraya R, Faroux R, Fourgeaud JL, Grimprel H, Auroux J, Rey JF, Arnoux JP, Lentini F, Mouterde O, Spyckerelle C, Vacherot B, Weissman A, Alpérine M, Le Sidaner A, Bonnet-Eymard PO, Colson JL, Pellet D, Deltombe B, Edouard A, Maechel H, Jaillet JC, Genes J, Leveque AM, Lucidarme D, Maignan P, Mallier Gehrke N, Sanchez J, Tusseau F, Casteur A, Bottlaender J, Constantini D, Coton T, Even P, Druart F, Riot F, Gauchet JM, Hecquet G, Henry G, Hochain P, Arpurt JP, Medini A, Dartois-Hoguin M, Moindrot H, Emery P, Periac P, Prunier A, Renkes P, Tawil C, Vincent E, Vitte RL, Loeb C, Carwana A, Barbereau D, Bohon P, Corrieri-Baizeau C, David D, Desbazeille F, Fontenelle P, Slama JL, Le Mercier Y, Certin M, Reig JJ, Rosa I, Helbert T, Tounian P, Turner L, Perot V, Aillet L, Pauwels A, Barré P, Nury B, Cazalbou C, Devulder F, Durget A, Dubroca J, Gaudy D, Greff M, Jacques C, Lafarge J, Kezachian G, Le Gall R, Pariente A, Pinault T, Bismuth M, Boyer N, Bretagnolle P, Carpentier S, Cholet F, Theodore C, Combes R, Combet F, Delanoe C, De Montigny S, Soudan D, Fourdan O, Minier G, Languepin J, Roche J, Ginies JL, Nouel O, Petitgars P, Robin E, Hamm R, Roques JF, Roussin-Bretagne S, Muron S, Bardoux N, Berthelemy P, Madonia P, Carles B, Reynier C, Cuillerier E, Dadamessi I, Danis J, Debenes B, Dubuc-Rey N, Lesur G, Jouet P, Lenaerts C, Garret M, Mineur A, Chabry B, Pigot F, Rossi V, Tennenbaum R, Salloum J, Slaoui MH, Mathieu S, Papapietro V, Viola S, Bezet A, Altman C, Audan A, Calabet J, Masliah C, Fayemendy L, Duruy M, Gauffeny B, Helie L, Imani K, Janin-Manificat R, Galmiche JP, Kerlirzin A, Bedenne L, Locher C, Michaudel G, Missonnier G, Rinaldi-Dovio M, Rouillon JM, Ecuer S, Patenotte A, Bronstein JA, Baty V, Bougnol M, Bourbon P, Cerbelaud P, Chavaillon A, Boiffin F, Dubern B, Duval De Laguierce I, Greco F, Bouhot F, Godeberge P, Grandmaison B, Gros P, Targues G, Corallo J, Boutin J, Guillan J, Barbieux JP, Loury Lariviere I, Le Genissel H, Leroi H, Bellaiche M, Elie-Legrand MC, Dapoigny M, Denoyel P, Pienkowski P, Pouche P, Saurfelt MM, Thorel JM, Piche T, Travers B, Tuvignon P, Zalcberg M, Boulay G, Zamora C, Samama J, Ricotie E, De Fleury P, Maille F, Mougenel JL, Gonot O, Menat JP, Kaassis M, Lang F, Abramowitz L, Ganne N, Pecriaux O, Seyrig JA, Sobhani I, Parmentier T, Van Nieuwenhuyse A, Weber FX, Glibert A, Bineau C, Canet B, Collin C, Cordet F, David Parlier D, Peytier A, Fein F, Barouk J, Dewannieux J, Hartwig J, Jouve JL, Laplane B, Lascar G, Legrand C, Le Marchand P, Liebaert MP, Terdiman-Pire M, Abdelli N, Neveu D, De La Lande P, de Saint Louvent P, Pelatan C, Petit A, Richecoeur M, Texier F, Cazals JB, Tissot B, Mourrut C, Doubremelle M, Foltz M, Gautier-Jubé F, Martin J, Khouri E, Lons T, Carlier-Bandu M, Monnin JL, Roche H, Willemin B, Houard X, Fatisse A, Algard M, Arab K, Borel I, Lagarrigue C, Chryssostalis A, Boutroux D, Dupuychaffray JP, Khaddari S, Mion F, Puy-Montbrun T, Girardet JP, Gury B, Landau A, Le Bihan M, Nieuviarts S, Ollivry J, Piquet MA, Escartin MP, Systchenko R, Venezia F, Wantiez M, Lesage X, Zrihen E, Aygalenq P, Dieumegard B, Savarieau B, Bulois P, Cattan S, Diez JL, Fauchot O, Durous E, Gazut V, Guilleminet C, Bories JM, Le Floch JI, Vove JP, Lelouch S, Lévy P, Lhopital F, Marcato N, Mozer-Bernardeau M, Nousbaum JB, Cattan P, Plane A, Raymond JM, Roseau G, Rozental G, Boustière C, Bonny C, Cordier-Collet M, Courat L, Croguennec B, Delaunay K, Labarriere D, Geagea E, Gottrand F, Gelsi E, Thiefin G, Wohlschies E, Miguet M, Ponsot P, Suzanne J, Teste Y, Dupont Gossart AC, Baroni JL, Benchaa B, Blanc G, Maroy B, Bonjean P, Brézault C, Bridoux-Henno L, Chayette C, Auby D, Fiorucci R, Galindo G, Hubert G, Bonneau G, Marinier E, Pouteau M, Alamdari A, Delbende B, Chamouard P, D'Abravanel C, Dall'Osto H, Hervé S, Lefebvre J, Levoir D, Lillo P, Rouch M, Mathonnet M, De Lustrac M, Ramond FJ, Roupret B, Soupison A, Ait-Ouadda D, Barbaza Y, Bayart B, Bottini T, Cochet F, Goderel I, Maury O, Mbonyingo L, Pourtau V, Romain-Huttin L, Sallé AV, Trang J, Admane H, Drouet E.

Abstract

BACKGROUND & AIMS:

Patients with inflammatory bowel disease (IBD) who have been exposed to thiopurines might have an increased risk of skin cancer. We assessed this risk among patients in France.

METHODS:

We performed a prospective observational cohort study of 19,486 patients with IBD, enrolled from May 2004 to June 2005, who were followed up until December 31, 2007. The incidence of nonmelanoma skin cancer (NMSC) in the general population, used for reference, was determined from the French Network of Cancer Registries.

RESULTS:

Before the age of 50 years, the crude incidence rates of NMSC among patients currently receiving or who previously received thiopurines were 0.66/1000 and 0.38/1000 patient-years, respectively; these values were 2.59/1000 and 1.96/1000 patient-years for the age group of 50 to 65 years and 4.04/1000 and 5.70/1000 patient-years for patients older than 65 years. Among patients who had never received thiopurines, the incidence of NMSC was zero before the age of 50 years, 0.60/1000 for the ages of 50 to 65 years, and 0.84/1000 for those older than 65 years. A multivariate Cox regression model stratified by propensity score quintiles showed that ongoing thiopurine treatment (hazard ratio [HR], 5.9; 95% confidence interval [CI], 2.1-16.4; P = .0006) and past thiopurine exposure (HR, 3.9; 95% CI, 1.3-12.1; P = .02) were risk factors for NMSC. They also identified age per 1-year increase as a risk factor for NMSC (HR, 1.08; 95% CI, 1.05-1.11; P < .0001).

CONCLUSIONS:

Ongoing and past exposure to thiopurines significantly increases the risk of NMSC in patients with IBD, even before the age of 50 years. These patients should be protected against UV radiation and receive lifelong dermatologic screening.

PMID:
21708105
DOI:
10.1053/j.gastro.2011.06.050
[Indexed for MEDLINE]
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