P79 Inflammatory bowel disease associated colorectal cancer: chemopreventive effects of 5-ASAs, immunomodulators, and biologics

Abstract

Introduction The incidence and mortality of colorectal cancer (CRC) remains elevated in the inflammatory bowel disease (IBD) population. We aimed to examine the association between biologics, 5-aminosalicylates (5-ASAs), and immunomodulators, with the risk of CRC and/or dysplasia in patients with IBD in a contemporaneous systematic review and meta-analysis.

Methods We searched Web of Science, PubMed, MEDLINE, and EMBASE from inception to 15th June 2024 for all studies assessing the impact of biologics, 5-ASAs and immunomodulators on the occurrence of CRC or dysplasia in adults (≥16 years) with IBD. Data were pooled using a random effects model generating relative risk (RR) estimates with 95% confidence intervals (CIs). (PROSPERO registration number: CRD42024559501).

Results Eleven studies containing 8,721 cases of CRC in 447,637 patients with IBD, 32 studies containing 9,847 cases of CRC among 462,408 patients with IBD, and 35 studies containing 10,794 cases of CRC in 544,380 patients with IBD were analysed for biologics, 5-ASAs, and immunomodulators, respectively. Biologic therapies (RR 0.74; 95% CI 0.64-0.85, I2 =56.8%) and 5-ASAs (RR 0.78; 95% CI 0.70-0.86, I2 =52.1%) were associated with a reduced risk of CRC and/or dysplasia in patients with IBD. Immunomodulators were not associated with a reduced risk (RR 0.91; 95% CI 0.82-1.02, I2 =82.7%).

Conclusions The use of biologics and 5-ASAs, but not immunomodulators, is associated with a reduced risk of CRC and/or dysplasia in patients with IBD.