P840 IBD-related malignancies and mortalities observed in 2015–2017: 3 years’ results from the prospective nationwide Hungarian registry

Abstract Background Inflammatory bowel diseases (IBD-Crohn’s disease (CD); ulcerative colitis (UC)) are lifelong inflammatory conditions of the gastrointestinal tract. Early literature suggests the overall excess mortality burden was negligible in UC and only marginally increased in CD compared with the general population. Emerging data are challenging earlier perceptions of IBD-associated mortality. The aim of our nationwide registry was to prospectively collect IBD-related mortalities and all types of malignancies diagnosed in the Hungarian IBD population. Methods Data on all death and malignancies developed between January 2015 and December 2017 in IBD patients were recorded. Each member of the Hungarian Society of Gastroenterology were prospectively interviewed 3 monthly by personal emails to report both death and malignancies observed in their patient population. Demographic and clinical data including previous immunosuppressive and biological therapy were also collected. Our definition of death possibly related with IBD: (1) cause of death is a consequence of a complication of IBD, (2) a consequence of IBD-related malignancy, or (3) a consequence of an infection during immunosuppressive therapy. Results Sixty-eight newly diagnosed malignancies were reported. More than half of the cancers were CRC (n = 36), one of them had pouch cancer previously colectomized because of sigmoid tumour. Other malignant diseases were registered in 32 cases. Twenty-eight of the 36 CRC cases were associated with UC, 60% with pancolitis. Twenty of the 36 cases were located in the rectosigmoid region, 2 had multiple localisation, 13 were located in the colon and one patient had pouch cancer after an IPAA procedure had performed because of UC-associated sigmoid tumour. 23 deaths were reported during the examined period. Eleven fatal cases were possibly related to IBD: 5 infection-related cases: 3 septic shock, 1 interstitial pneumonitis, 1 meningitis; 3 cancer-related cases: 1 rectal and 1 pouch cancer, 1 pancreatic cancer (associated with PSC); 3 disease-related: 1 haemorrhagic shock, 1 intestinal perforation and 1 treatment refractory, serious malnutrition. Age of death was significantly lower in case of IBD-related mortality compared with the other patients and general population (41.6 vs. 64.3 vs. 73.4 (data from Central Statistical Office 2013, Hungary) years, p < 0.05). Conclusions The most frequently observed IBD-related malignancy is CRC, which can be multifocal and