The Complex Interplay Between Inflammatory Bowel Disease and Malignancy

  • Jessica KimmelEmail author
  • Jordan Axelrad
Inflammatory Bowel Disease (M Regueiro, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Inflammatory Bowel Disease


Purpose of Review

Both the chronic inflammation in inflammatory bowel disease (IBD), and its treatment, can increase the risk of malignancy. There is also an increasing number of patients with current and prior cancer who require IBD treatment. Thus, there is a complex interplay between immunosuppressive treatment and monitoring for new and recurrent cancer.

Recent Findings

Vedolizumab and ustekinumab have not been shown to increase the risk of malignancy. Transplant data shows a potential risk with tofacitinib although rheumatoid arthritis data does not. IBD patients have been shown to tolerate chemotherapy, specifically with cytotoxic compared with hormonal chemotherapy. Patients with prior cancer are at increased risk of new or recurrent cancers; however, immunosuppression appears to be safe.


Emerging treatments for IBD have demonstrated acceptable safety profiles for malignancy risk, and immunosuppression appears to be safe for use in patients with current and prior malignancy. More data is still needed to assess long-term risk of malignancy in these patients, especially with newer treatments.


Inflammatory bowel disease Crohn’s disease Ulcerative colitis Malignancy Cancer 


Compliance with Ethical Standards

Conflict of Interest

Dr. Kimmel declares no conflict of interest. Dr. Axelrad declares no conflict of interest.

Human and Animal Rights

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Division of Gastroenterology, Department of MedicineNew York University School of MedicineNew YorkUSA
  2. 2.Division of Gastroenterology, Department of Medicine, Inflammatory Bowel Disease Center at New York University Langone HealthNew York University School of MedicineNew YorkUSA

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