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Study IDs predictors of nonmelanoma skin cancer in IBD



Male gender and white race rank among epidemiologic risk factors that predict which inflammatory bowel disease (IBD) patients go on to develop nonmelanoma skin cancer, a large national analysis showed.

“Some studies have shown that patients with IBD may be at increased risk for nonmelanoma skin cancer (NMSC) because of the immunomodulators that they take for the management of their disease,” Zubair Khan, MD, said in an interview at the Crohn’s & Colitis Congress, a partnership of the Crohn’s & Colitis Foundation and the American Gastroenterological Association. “But these are mostly small, single-center studies.” In an effort to determine the epidemiology of NMSC in patients hospitalized with IBD, Dr. Khan, associate chief resident in the internal medicine department at the University of Toledo (Ohio) Medical Center and his associates analyzed the National Inpatient Sample (NIS) database for all subjects who had a primary or secondary discharge diagnosis of IBD during 2002-2014. Next, they used ICD-9 codes to identify the rate of NMSC in this population.

Zubair Khan, MD, associate chief resident in the internal medicine department at the University of Toledo (Ohio) Medical Center. Doug Brunk/Frontline Medical News

Dr. Zubair Khan

In all, there were 22,620 discharges of NMSC in IBD patients during the time period, which constituted 0.7% of IBD discharges. Out of these, 9,097 were cases of ulcerative colitis and 3,523 were cases of Crohn’s disease. Most of the patients with NMSC were above the age of 50 (90%), with the highest prevalence in those aged 71-80 years (28%).

Compared with IBD patients without NMSC, most of the IBD patients with NMSC were males (54% vs. 42%; P less than 0.001), covered by Medicare (65% vs. 37%), were white (96% vs. 81%; P less than .001), lived in the Midwest or Western United States (27% and 26% vs. 22% and 17%), were admitted to urban teaching hospitals (57% vs. 51%; P less than .001), were discharged to skilled nursing facilities (16% vs. 10%; P less than .001), required home health care (17% vs. 11%), and were admitted electively (27% vs. 20%). The researchers observed no significant difference in mortality among IBD patients with and without NMSC (1.61% vs. 1.53%; P = .22).

Multivariate analysis revealed that the following factors were predictive of NMSC in IBD: comorbid diagnosis of rheumatoid arthritis, collagen vasculature diseases, male sex, and white race. “Patients with those risk factors should be made more aware of their risk for developing NMSC,” Dr. Khan said. “They shouldn’t be taken lightly.”

Dr. Khan reported having no financial disclosures.

*This story was updated on 3/26.

SOURCE: Khan Z et al. Crohn’s & Colitis Congress, Poster 209.

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