ArticleJournal of Crohn's & colitis2025
Cancer incidence in patients with ulcerative colitis naïve to or treated with thiopurine and targeted therapies-a cohort study 2007 to 2022 with comparison to the general population.
Article in Journal of Crohn's & colitis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Declining rates of surgery in pediatric-onset inflammatory bowel disease: a Swedish nationwide register-based cohort study 2002-2022.Journal of Crohn's & colitis · 2026Article
- In Vitro and In Vivo Efficacy of Epithelial Barrier-Promoting Barriolides as Potential Therapy for Ulcerative Colitis.Biomedicines · 2026Article
- Colorectal cancer in ulcerative colitis: unraveling mechanisms and advancing surveillance and chemoprevention.Frontiers in oncology · 2026Review
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9 authors.
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Abstract
backgroundCancer incidence data including absolute risk differences are needed for clinical risk communication to patients receiving modern-day treatments for ulcerative colitis (UC).
methodsWe linked nationwide Swedish health registers and assessed incident cancers in patients with UC in 2007-2022. We computed age-stratified incidence rates (IRs), IR differences, and hazard ratios (HRs) in a naïve cohort with no immunomodulatory treatment, and in cohorts treated with thiopurine or targeted therapies. General population comparator subjects were matched (by age, sex, calendar year, and area of residence) to each treatment cohort. We used a once-exposed-always-exposed design.
resultsWe identified 63 925 patients with UC in partly overlapping cohorts and 593 072 comparators with a total follow-up time of 5 800 089 years (median 8.1 years). The IRs were elevated compared to the general population in naïve patients: 2.7 extra cancer cases per 1000 person-years (HR: 1.12, 95% CI, 1.09-1.16), in thiopurine-treated patients: 3.4 extra cases (HR: 1.48;1.37-1.61), tumor necrosis factor inhibitor (TNFi)-treated: 2.7 extra cases (HR: 1.41;1.24-1.62), Thiopurine + TNFi-treated: 2.42 extra cases (HR: 1.44;1.19-1.75), vedolizumab-treated: 2.88 extra cases (HR: 1.27;0.90-1.79). The IR differences were not significantly increased in patients treated with ustekinumab 0.57 (HR: 0.87;0,39-1.93) and tofacitinib -0.69 (HR: 0.84;0.25-2.77). Across all treatment groups, the IR differences compared to the general population were highest in patients ≥ 60 years. The differences were driven by colorectal cancer, hepatobiliary cancer, lymphoma, and basal cell skin carcinoma.
conclusionsElevated cancer incidence was observed in patients with UC amounting to around 3 extra cases of cancer per 1000 years. Cancer risks varied more among groups defined by age than by treatment.
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