1The Leona M. Harry B. Helmsley Inflammatory Bowel Disease Center, The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, 10029 NY, USA.
2Department of Pathology & The Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, 10029 NY, USA.
3The Leona M. Harry B. Helmsley Inflammatory Bowel Disease Center, The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, 10029 NY, USA. Electronic address: email@example.com.
BACKGROUND & AIMS:
Epidemiology studies have consistently found an increased risk of oral malignancies in organ transplant recipients, patients with graft vs host disease, and people with HIV infection. We assessed the risk of oral cancer in the patients with inflammatory bowel diseases (IBD).
We collected data on 7294 patients with IBD (3785 women) seen at Mount Sinai Medical Center, NY from 2000 through 2011. The expected incidence of oral cancer was calculated for each sex- and 5-year age-specific stratum by specific incidence rates using the SEER 18 registry data (2000-2011), adjusted for age to the 2000 United States population (census P25-1130).
Eleven patients (7 men) were found to have biopsy-proven oral cancer. Six patients had cancer of the tongue, 2 patients had cancer of the hard palate, and the remaining 3 had tonsular, buccal, or mandibular sarcoma. Before the cancer diagnosis, IBD had been treated in 4 patients with azathioprine or mercaptopurine, in 1 patient with infliximab, and 3 in patients with combination of biologic agents and azathioprine; 4 of the patients had not been treated for IBD. The age- and sex-adjusted standardized incidence ratio (SIR) for oral cancer in patients with IBD was 9.77 (95% confidence interval [CI], 5.14-16.98). In women, the SIR was 12.07 (95% CI, 3.84-29.11) and in men, the SIR was 8.49 (95% CI, 3.71-16.78). The age-adjusted SIR for tongue cancer was 18.91 (95% CI, 7.66-39.33): 17.06 for men (95% CI, 5.42-41.15) and 22.10 for women (95% CI, 3.70-73.01).
We found patients with IBD to be at increased risk for oral cancers-especially tongue cancer. Women are at higher risk than men.