Cancers Complicating Inflammatory Bowel Disease
Cette étude fait le point sur l'association entre des maladies inflammatoires chroniques de l'intestin, des facteurs liés au mode de vie tels que le tabagisme, l'utilisation de médicaments immunosuppresseurs pour traiter ces inflammations et le risque de cancers
Crohn’s disease and ulcerative colitis are lifelong inflammatory bowel diseases of unknown origin that generally begin in young adulthood. It is estimated that at least 0.4% of Europeans and North Americans live with inflammatory bowel disease. Life expectancy is reduced in patients with Crohn’s disease and in patients with ulcerative colitis that is diagnosed when colitis is extensive or that is diagnosed in childhood. There are excess deaths from infection, cardiovascular diseases, and cancers in patients with inflammatory bowel disease.3 Some differences in the risk of cancer between patients with inflammatory bowel disease and the general population may be the result of differences in the distribution of lifestyle factors. For example, smokers are overrepresented among patients with Crohn’s disease, and this overrepresentation results in an excess rate of smoking-related cancers in the total population with Crohn’s disease. Conversely, nonsmokers are overrepresented among patients with ulcerative colitis, so there is a decreased rate of such cancers in the total population with ulcerative colitis. The focus of this review is on the epidemiologic characteristics, carcinogenesis, and prevention of excess cancers that can be attributed to chronic intestinal inflammation or to the carcinogenic effects of the immunosuppressive drugs used to treat inflammatory bowel disease.