Older people with inflammatory bowel disease have a higher cancer rate than younger IBD patients and the general population, a study reports.
The research, “Risk of Malignancy in a Nationwide Cohort of Elderly Inflammatory Bowel Disease Patients,” appeared in the journal Drugs & Aging.
The number of people with IBD, which includes Crohn’s and ulcerative colitis, is increasing. Because people are living longer, the number of older IBD patients is expected to increase dramatically. Older people are also prone to developing other conditions, including high blood pressure and cancer.
Researchers wanted to determine the risk of IBD patients developing cancer.
They looked at patient records between 2010 and 2014 in the Truven Health Analytics MarketScan database. It covers health claims filed with U.S. insurance companies and the government’s Medicare insurance program.
The database included 54,971 IBD patients between 18 and 64 years of age and 8,788 who were 65 and older. Researchers followed the younger group a median of 22 months and the older group 24 months. They excluded patients who had cancer before the start of their study.
When the research began, 96 percent of the older patients were receiving corticosteroids, versus 90 percent of the younger ones.
But higher percentages of the younger group were receiving biologics and immunomodulators, a trend that has been studied before.The figures were 19 percent of the younger group using biologics, versus 6 percent of the older group, and 21 percent using immunomodulators, versus 11 percent of the older patients.
A key finding was that older IBD patients had four times the cancer rate of younger ones and almost double the rate of that in the general population.
The study identified a number of other factors associated with an increased risk of cancer. One was that men with an IBD were more likely to develop cancer than women.
Other factors included how long it had been since a person had received an IBD diagnosis, whether they had taken corticosteroids, whether they were taking at least five medications, and whether they had high blood pressure.
A dramatic finding was that taking corticosteroids during the study’s follow-up period increased a patient’s risk of developing cancer by 35 percent.
After accounting for these additional factors, the researchers reported that older IBD patients’ risk of developing cancer was three times that of younger patients.
Older patients were not at increased risk of developing particular types of cancer, the researchers discovered. Instead, they learned that certain cancers were more common in the IBD patient population as a whole than in the general population. They included colorectal, lung, breast, prostate and urinary tract cancer, plus non-Hodgkin’s lymphoma.
The study underscored the much higher risk of an older IBD patient developing cancer. Physicians need to be aware of the increased risk and screen these patients for cancer, researchers said.