ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2026
Cancer Risk With Advanced Therapies in Patients With Inflammatory Bowel Diseases: An Administrative Claims-Based Study.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND &
aimsWe conducted a retrospective cohort study comparing the risk of cancer in patients with inflammatory bowel diseases (IBDs) initiating advanced therapies (ATs).
methodsUsing an administrative claims database (OptumLabs Data Warehouse), we identified patients with IBD with no prior history of cancer, who initiated tumor necrosis factor (TNF) antagonists, vedolizumab, anti-interleukins (ILs), or Janus kinase (JAK) inhibitors between 2016 and 2023 and had insurance coverage for at least 1 year before and after treatment initiation. We compared risk of overall cancer (except nonmelanoma skin cancer) across different ATs occurring at least 3 months after treatment initiation. Groups were balanced through multinomial propensity score-based inverse probability weighting. We calculated cause-specific hazard ratios (HRs) and 95% confidence intervals (CIs).
resultsOf 15,687 patients with IBD starting an AT (age, 45 ± 17 years; 52% female; 76% White; 14% with obesity) and followed over a median of 2.6 years, 273 developed cancer. The 3-year cumulative incidence of cancer was similar across all agents: TNF antagonists (n = 8031), 2.1% (95% CI, 1.7-2.5); vedolizumab (n = 3985), 2.7% (95% CI, 2.1-3.3); anti-ILs (n = 3287), 2.0% (95% CI, 1.4-2.6); and JAK inhibitors (n = 384), 2.5% (95% CI, 0.5-4.6). After adjusting for confounding variables, risk of cancer with ATs was comparable (HR, vs TNF antagonists): vedolizumab, 1.01 (95% CI, 0.71-1.42); anti-ILs, 0.94 (95% CI, 0.61-1.46); JAK inhibitors, 0.85 (95% CI, 0.33-2.16). The findings were similar on subgroup analyses based on type of cancer (solid organ, hematologic, melanoma), and on multiple sensitivity analyses. Findings were consistent in agent-level analyses and in an indirect comparison with a cohort of immunomodulator- and advanced therapy-naïve patients with newly diagnosed IBD.
conclusionsIn a real-world cohort of 15,687 patients with IBD initiating ATs, risk of incident cancer was low and comparable across advanced therapy classes.
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