The incidence of lymphoproliferative disorders (LD) is increasing in developed countries. Patients with inflammatory bowel disease (IBD) exposed to thiopurines are at additional risk of three specific forms of LD: Epstein-Barr-Virus-related post-transplant like LD, hepato-splenic T-cell lymphoma and post-mononucleosis lymphoproliferation. The risk of the two latter forms of LD can be reduced when considering specific immunosuppressive strategies in young males. It is still unclear whether the risk of uterine cervix abnormalities is increased in IBD women, irrespective of the use of immunosuppressants. Given the excess risk demonstrated in various other contexts of immunosuppression, it is currently recommended that all women with IBD, particularly those receiving immunosuppressants, strictly adhere to a screening program of cervical surveillance and undergo vaccination against HPV, when appropriate. Patients with IBD receiving immunosuppressants are at increased risk of skin cancers. The risk of non-melanoma skin cancer is notably increased in patients receiving thiopurines. Recent data suggest that the risk of melanoma is mildly increased in patients exposed to anti-TNF therapy. All IBD patients should adhere to a program of sun protection and dermatological surveillance, whose details should take into account the other non-IBD-related risk factors.
Keywords: Anti-TNF therapy; BCC; CD; CIN; COC; Cervical intra-epithelial neoplasia; Combination oral contraceptive; Crohn's disease; EBV; Epstein–Barr Virus; Extraintestinal cancers; HLH; HPV; HSTCL; Haemophagocytic lymphohystiocytosis; Hepatosplenic T-cell lymphoma; Human papilloma virus; IBD; Immunosuppressive therapy; Inflammatory bowel diseases; LD; Lymphomas; OR; Odds ratio; PaP; Papanicolaou; SCC; SIR; Skin cancers; Squamous cell carcinoma; Standardized incidence ratio; Thiopurines; UC; UV; Ulcerative colitis; Ultraviolet; Uterine cervix cancers; X-linked lymphoproliferative syndrome; XLP syndrome; basal cell carcinoma; lymphoproliferative disorder.
Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.