Cancer and inflammatory bowel disease in the elderly

Dig Liver Dis. 2016 Oct;48(10):1105-11. doi: 10.1016/j.dld.2016.05.006. Epub 2016 May 20.

Abstract

Cancer may be a complication of inflammatory bowel disease (IBD) or its treatments. In older Crohn's disease and ulcerative colitis patients, the risk of malignancy is of particular concern. IBD diagnosis at an advanced age is associated with earlier development of colitis-associated colorectal cancer. Thiopurine use in older IBD patients is tied to an increased risk of non-Hodgkin's lymphoma, nonmelanoma skin cancer, and urinary tract cancers. Additionally, older age is accompanied by multimorbidity, an increased risk of malnutrition, and decreased life expectancy, factors that complicate the management of cancer in the elderly. The optimal approach to the increased risk of malignancy in older age IBD is appropriate cancer screening and medical treatment. This may include age-specific colorectal cancer screening and limiting UV radiation exposure. With a growing number of older IBD patients, further studies are necessary to delineate the risk of cancer in this population.

Keywords: Crohn's disease; Malignancy; Older; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aged
  • Colorectal Neoplasms / epidemiology*
  • Early Detection of Cancer
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / drug therapy
  • Lymphoma, Non-Hodgkin / chemically induced
  • Lymphoma, Non-Hodgkin / epidemiology*
  • Mercaptopurine / adverse effects*
  • Skin Neoplasms / epidemiology
  • Urologic Neoplasms / epidemiology

Substances

  • Mercaptopurine