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

Peyrin-Biroulet, Laurent, Khosrotehrani, Kiarash, Carrat, Fabrice, Bouvier, Anne-Marie, Chevaux, Jean-Baptiste, Simon, Tabassome, Carbonnel, Frank, Colombel, Jean-Frederic, Dupas, Jean-Louis, Godeberge, Philippe, Hugot, Jean-Pierre, Lemann, Marc, Nahon, Stephane, Sabate, Jean-Marc, Tucat, Gilbert, Beaugerie, Laurent and For the Cesame Study Group (2011) Increased risk for nonmelanoma skin cancers in patients who receive thiopurines for inflammatory bowel disease. Gastroenterology, 141 5: 1621-1628.e5. doi:10.1053/j.gastro.2011.06.050


Author Peyrin-Biroulet, Laurent
Khosrotehrani, Kiarash
Carrat, Fabrice
Bouvier, Anne-Marie
Chevaux, Jean-Baptiste
Simon, Tabassome
Carbonnel, Frank
Colombel, Jean-Frederic
Dupas, Jean-Louis
Godeberge, Philippe
Hugot, Jean-Pierre
Lemann, Marc
Nahon, Stephane
Sabate, Jean-Marc
Tucat, Gilbert
Beaugerie, Laurent
For the Cesame Study Group
Title Increased risk for nonmelanoma skin cancers in patients who receive thiopurines for inflammatory bowel disease
Journal name Gastroenterology   Check publisher's open access policy
ISSN 0016-5085
1528-0012
Publication date 2011-11-01
Sub-type Article (original research)
DOI 10.1053/j.gastro.2011.06.050
Volume 141
Issue 5
Start page 1621
End page 1628.e5
Total pages 13
Place of publication Maryland Heights, MO, United States
Publisher W.B. Saunders
Collection year 2012
Language eng
Formatted 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.
Keyword CESAME Study
Therapy
Crohn’s Disease
Colitis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 25 June 2011.

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2012 Collection
School of Medicine Publications
 
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Created: Wed, 19 Oct 2011, 22:03:52 EST by Dr Kiarash Khosrotehrani on behalf of Medicine - Princess Alexandra Hospital