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Gut. 2014 Sep;63(9):1416-23. doi: 10.1136/gutjnl-2013-305763. Epub 2013 Oct 25.

Risk of new or recurrent cancer under immunosuppressive therapy in patients with IBD and previous cancer.

Collaborators (697)

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, Marteau P, Soulé J, Gornet JM, Veyrac M, Duclos B, Beau P, Bourreille A, Baumer P, Carbonnel F, Heresbach D, Metman EH, Florent C, Blain A, Faucheron JL, Bonaz B, Roblin X, Potier P, Boehm C, Kurtz T, Lamouliatte H, Nion-Larmurier I, Delchier JC, Chaussade S, Weiss AM, Cézard JP, 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, D'aubigny ND, Uettwiller H, Mallet AC, 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, Lamy P, 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 JP, 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 J, 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, Prades P, Boulant J, Diacono M, Monsch JM, Dupuy JF, Bellaiche G, Guegan M, Comte JM, Cayla JM, Tallec FL, Meurisse F, Desurmont P, Roget L, Bouyssou P, Gall BL, 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, Dramard JM, 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 J, Ink O, Blondel F, 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, Ferbus DC, Contou JF, Coupier D, David B, Gargot D, Huc D, Barraya R, Faroux R, Fourgeaud J, Grimprel H, Auroux J, Rey JF, Arnoux JP, Lentini F, Tardy L, Mouterde O, Spyckerelle C, Vacherot B, Weissman A, Alpérine M, Sidaner AL, Bonnet-Eymard PO, Colson JL, Pellet D, Deltombe B, Edouard A, Maechel H, Jaillet JC, Genes J, Leveque AM, Lucidarme D, Maignan P, Gehrke NM, 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-Longreen C, Vincent E, Vitte RL, Loeb C, Carwana A, Barbereau D, Bohon P, Corrieri-Baizeau C, Sahy D, Derreveaux P, David D, Desbazeille F, Fontenelle P, Slama JL, Mercier YL, 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, Gall RL, Pariente A, Pinault T, Bismuth M, Boyer-Darrigrand 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, Sénéjoux A, 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, De Laguierce ID, Greco F, Bouhot F, Godeberge P, Grandmaison B, Gros P, Targues G, Corallo J, Boutin J, Guillan J, Barbieux JP, Lariviere IL, Genissel HL, 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, Parlier DD, Carre D, Peytier A, Fein F, Barouk J, Dewannieux J, Hartwig J, Jouve JL, Laplane B, Lascar G, Legrand C, Marchand PL, 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 J, Khaddari S, Mion F, Puy-Montbrun T, Girardet JP, Gury B, Landau A, Bihan ML, Nieuviarts S, Ollivry J, Bourgeois PL, Piquet M, Escartin M-, 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, Floch IJ, 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- Tardy K, Labarriere D, Geagea E, Gottrand F, Gelsi E, Thiefin G, Wohlschies E, Miguet M, Ponsot P, Suzanne J, Teste Y, 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 P, 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, Rasoanarivo E, Romain-Huttin L, Sallé AV, Trang J, Admane H, Drouet E.

Abstract

OBJECTIVE:

To explore the risk of new or recurrent cancer among patients with IBD and previous cancer, exposed or not to immunosuppressants.

DESIGN:

Among the 17 047 patients of the CESAME prospective observational cohort who were enrolled from May 2004 to June 2005, and followed-up until December 2007, we identified 405 patients with cancer diagnosed previous to study entry. We calculated the rates of incident cancer in patients with or without previous cancer, and we assessed by survival analysis and nested case-control study the impact of immunosuppressants on the risk of incident new or recurrent cancer in patients with previous cancer.

RESULTS:

The rate of incident cancer was 21.1/1000 patient-years (PY) and 6.1/1000 PY in patients with and without previous cancer, respectively. The multivariate-adjusted HR of incident cancer between patients with and without previous cancer was 1.9 (95% CI 1.2 to 3.0, p=0.003). Among patients with previous cancer, the rates of new and recurrent cancers were, respectively, 13.2/1000 PY and 6.0/1000 PY in the 312 patients who were not taking immunosuppressant at the time of study entry, and 23.1/1000 PY and 3.9/1000 PY in the 93 patients treated with immunosuppressants at study entry. There was no significant association between the exposure to immunosuppressants and the risk of new or recurrent cancer.

CONCLUSIONS:

Patients with IBD with a history of cancer are at increased risk of developing any (new or recurrent) cancer, with a predominant incidence of new cancers. Treatment with immunosuppressants has no overall major impact per se on this risk.

KEYWORDS:

Azathioprine; Cancer Epidemiology; Crohn's Disease; Ulcerative Colitis

PMID:
24162591
DOI:
10.1136/gutjnl-2013-305763
[Indexed for MEDLINE]
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