The effects of aminosalicylates or thiopurines on the risk of colorectal cancer in inflammatory bowel disease
Open accessAbstract
BACKGROUND: Whether aminosalicylates or thiopurines reduce the risk of colorectal cancer (CRC) in inflammatory bowel (IBD) disease is controversial. AIM: To assess simultaneously the chemopreventive effect of aminosalicylates or thiopurines in a case-control study nested in the CESAME observational cohort that enrolled consecutive patients with IBD between May 2004 and June 2005. Patients were followed up to December 2007. METHODS: Study population comprised 144 case patients who developed CRC from the diagnosis of IBD (65 and 79 cases diagnosed, respectively, before and from 2004, starting year of the prospective observational period of CESAME) and 286 controls matched for gender, age, IBD subtype and year of diagnosis, and cumulative extent of colitis. Exposure to aminosalicylates or thiopurines was defined by an exposure to the treatment during the year of the diagnosis of cancer. The propensity of receiving 5-ASA and thiopurines was quantified by a composite score taking into account patient and IBD characteristics. The role of aminosalicylates or thiopurines was assessed by multivariate analysis. Propensity scores and the history of primary sclerosing cholangitis were entered into the multivariate model for adjustment. RESULTS: By multivariate analysis adjusted for propensity, a significant protective effect of exposure to drugs during the year of cancer was found for aminosalicylates (OR = 0.587, 95% CI: 0.367-0.937, P = 0.0257), but not for thiopurines (OR = 0.762, 95% CI: 0.432-1.343, P = 0.3468). CONCLUSION: In a case-control study nested in the CESAME cohort, a significant decrease in the risk of colorectal cancer in IBD was associated with exposure to aminosalicylates, not to thiopurines.
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5-aminosalicylic acid reduces the risk of development of colorectal cancer/dysplasia in colitis.
“5-aminosalicylic acid is recommended in colitis because it reduces the risk of development of colorectal cancer/dysplasia.374”
From EASL Clinical Practice Guidelines on sclerosing cholangitis (2022) · cites this paper as [374]
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Kefayat, A., Porter, R. J., Churchhouse, A. M. D., Blackwell, J., Watson, E., Morris, A. J., Gordon, M. A., Nigam, G. B., East, J. E., Rutter, M. D., et al. (2025) · Frontline Gastroenterology · doi:10.1136/flgastro-2025-103409 · Cited by 1 · see citing works
Ogurchyenok, N. E., Khalin, K. D., & Bryukhovetskiy, I. (2024) · Medicine International · doi:10.3892/mi.2024.149
Raicopol, M. D., Hanganu, A., Samoilă, I., Dinescu, S., Costache, M., Balaș, M., Chiriţă, C., Șeremet, O. C., Olaru, O. T., Nicolescu, F., et al. (2024) · Journal of Drug Delivery Science and Technology · doi:10.1016/j.jddst.2024.106188
- Authors
- Carrat, F., Seksik, P., Colombel, J.-F., Peyrin-Biroulet, L., Beaugerie, L., & the CESAME Study Group
- Affiliations
- Hôpital Saint-Antoine (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Icahn School of Medicine at Mount Sinai (US)
- Inserm U954 and Department of Hepato-Gastroenterology; University Hospital of Nancy; Lorraine University; Vandoeuvre-lès-Nancy France
- Corresponding author
- Beaugerie, L.
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2016-12-19
- Volume
- 45
- Issue
- 4
- Pages
- 533-541
- ISSN
- 0269-2813 (ISSN-L)
- OpenAlex
- W2567029831
- Cited by
- 49
- References
- 25
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 6 · 2023: 6 · 2022: 6 · 2021: 8 · 2020: 3 · 2019: 2 · 2018: 8 · 2017: 3
- FWCI
- 3.50
- Type
- journal article
- Language
- en
- Open access
- green
- hal.science
- Licence
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Funders
- Programme Hospitalier de Recherche Clinique National (AOM05157)
- Association François Aupetit
- Délégation Inter-régionale de la Recherche clinique Ile de France-AP-HP
- Ligue Contre le Cancer
- Fonds de Recherche de la Société Nationale Française de Gastro-Entérologie
- Ferring
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Health Sciences › Medicine › Pharmacology › Inflammatory mediators and NSAID effects
- Keywords
- aminosalicylates, thiopurines, colorectal cancer, inflammatory bowel disease, chemoprevention, 5-aminosalicylic acid, primary sclerosing cholangitis, cancer risk reduction
- MeSH terms
- Adult, Aged, Aminosalicylic Acids, Anti-Inflammatory Agents, Non-Steroidal, Colitis, Female, Humans, Male, Middle Aged, Prospective Studies, Retrospective Studies, Risk Factors, Colorectal Neoplasms, Inflammatory Bowel Diseases, Multivariate Analysis, Case-Control Studies, Treatment Outcome, Mesalamine
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