ROGERS PRIZE 6

Title, Authors and Institutions: / Risk of non-melanoma skin cancer risk in patients with inflammatory bowel disease – a single centre retrospective cohort study.
J Clowry1, J Sheridan2,R Healy3, S Deady4, D Keegan2, K Byrne2, G Cullen2, H Mulcahy2, H Comber4, A Parnell3,G Doherty2, A Lally11Department of Dermatology; 2Department of Gastroenterology,St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland.3Department of Statistics, School of Mathematical Sciences, University College Dublin, Belfield, Dublin 4, Ireland,4National Cancer Registry of Ireland, Kinsale Road, Cork, Ireland
Abstract:
(Your abstract must use Normal style and must fit in this space) / Background: Recent studies demonstrate an increased risk of non-melanoma skin cancer (NMSC) in immunosuppressed patients with inflammatory bowel disease (IBD).
Objectives: To investigate NMSC incidence and risk factors for NMSC in patients with IBD and compare with NMSC rates in the general population.
Methods:This was aretrospective single centre cohort study. Patients with IBD attending a tertiary referral adult hospital between 1994 and 2013 were included in this study. Skin cancer incidence in these patients was compared with records for the general population from the National Cancer Registry of Ireland (NCRI). Standardised incidence ratios (SIRs) for NMSC were calculated and logistic regression analysis used to investigate risk factors for NMSC in this population.
Results:2053 patients with IBD were studied.The SIR for NMSC in immunosuppressed patients with IBD was 1.8 (95% CI 1.0-2.7). The increased rate of NMSC in this group was greater in younger patients. The SIR for NMSC in all patients with IBD was 1.3 but this did not reach statistical significance (95% CI 0.9-1.8). Aging (p<0.001), exposure to azathioprine (p<0.001) and anti-tumour necrosis factor (TNF) drugs (p = 0.009) were significantly associated with the development of NMSC. Notably, 74% of patients exposed to an anti-TNF also had azathioprine exposure.
Conclusions: Compliance with measures for prevention of skin cancer should be highlighted to all patients with IBD, who are at a small but significantly higher risk of developing non-melanoma skin cancers. This single centre study identifies younger patients with inflammatory bowel disease exposed to azathioprine are a high-risk group for development of non-melanoma skin cancer. Consideration should be given to targeting skin cancer screening to this group.
  1. Long MD, Herfarth HH, Pipkin CA, Porter CQ, Sandler RS, Kappelman MD. Increased risk for non-melanoma skin cancer in patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2010;8(3):268-74.
  2. Peyrin-Biroulet L, Khosrotehrani K, Carrat F, Bouvier AM, Chevaux JB, Simon T, et al. Increased risk for nonmelanoma skin cancers in patients who receive thiopurines for inflammatory bowel disease. Gastroenterology. 2011;141(5):1621-28.e1-5.

Please return to closing date 26th August 2015