P1222Intestinal - extraintestinal malignancies and potential risk factors in IBD patients: Data from 5 tertiary centres in Greece

Background Patients with IBD are at increased risk of developing both intestinal and extraintestinal malignancies, attributed either to inflammatory burden or therapeutic regimens1,2. The purpose of this study is to register neoplasia cases of IBD patients in Greece. Methods The records of all IBD patients followed in five tertiary hospitals over the last decade were retrospectively studied. Patient and disease characteristics, family history of neoplasia, IBD activity at the time of neoplasia diagnosis, treatment regimens before, during and after neoplasia diagnosis, as well as the neoplasia’s outcome, were recorded and analysed. For data analysis, patients were divided into two groups based on whether neoplasia was diagnosed before or after IBD onset and exposure to related medications. The data were analysed with XLSTAT software. Results From 3320 patients’ records, 107 (3.2%) neoplasia cases were identified; 54.2% with CD, 57% male, with a median age at the time of neoplasia diagnosis of 58 years. Neoplasia was diagnosed before or simultaneously with IBD onset in 17 and 3 cases, respectively (15.9 and 2.8%). Demographics and clinical characteristics are summarised in Table 1. The most common malignancies involved the intestine (14.9%), respiratory (14.9%), cutaneous (13.1%), and reproductive systems (13.1%). In patients with a malignancy diagnosis prior to IBD, a predominance of endocrine neoplasms was observed (29.4%). Former or active smoking was reported by 69.2% of the patients, whereas no specific association between family history of cancer, EIMs, or active disease and neoplasia diagnosis emerged. The treatment regimens before, at the time of and after neoplasia diagnosis are illustrated in Figure 1. During 512 patient-years of follow-up, 4 recurrences of neoplasia and 24 deaths were recorded, 21 of which occurred within one year following neoplasia diagnosis and were considered related to it. Higher mortality rates were observed in patients with respiratory and intestinal neoplasia (33.3% and 23.9% of the cases, respectively). Most deceased patients had CD (RR: 1.69, 95% CI: 0.76-3.75), male sex (RR: 4.52, 95% CI: 1.54-13.29), smoking history (RR: 19, 95% CI: 1.2-314) and disease activity (RR: 1.15, 95% CI: 1.15-5.76). Mean age and IBD duration at neoplasia diagnosis were 58 (21) and 15 (14) years vs 53 (22) and 11.5 (11) years in non-deceased patients, respectively. Conclusion Neoplasia in patients with IBD primarily involves the intestinal, respiratory, cutaneous, and reproductive systems. CD, male sex and smoking represent potential risk factors for neoplasia occurrence and poor outcomes. Larger records are needed to identify well-demonstrated risk factors and establish control programs. References: 1. Gordon H, Biancone L, Fiorino G, et al. ECCO Guidelines on Inflammatory Bowel Disease and Malignancies. Journal of Crohn’s & Colitis. Published online December 18, 2022:jjac187. doi:https://doi.org/10.1093/ecco-jcc/jjac187 2. Massano A, Bertin L, Zingone F, et al. Extraintestinal Cancers in Inflammatory Bowel Disease: A Literature Review. Cancers. 2023;15(15):3824. doi:https://doi.org/10.3390/cancers15153824 Conflict of interest: Pagoni, Anna: No conflict of interest Zacharopoulou, Eirini: No conflict of interest Viazis, Nikolaos: No conflict of interest Aravantinoy Koytsoyvi, Artemis Stavroyla: No conflict of interest Bali, Maria: No conflict of interest Dellaporta, Ioanna: No conflict of interest Ioannou, Alexandros: No conflict of interest Kyriakos, Nikolaos: No conflict of interest Liatsos, Christos: No conflict of interest Michopoulos, Spyridon: No conflict of interest Mousourakis, Konstantinos: No conflict of interest Theocharis, Georgios: No conflict of interest Zampeli, Evanthia: I have received honor-aria and speaker fees from Abbvie, Janssen, Pfizer,Takeda, MSD, AMGEN, Genesis, Ferring, Mylan, BMS, Galenica Tzouvala, Maria: No conflict of interest