Does Crohn's disease therapy raise the risk of skin cancer?
If you are diagnosed with Crohn's disease, it's important that your doctor check your skin regularly. A recently published finding suggests the inflammatory bowel disease (IBD) can raise risk of melanoma. But what about other types of skin cancer that could be a risk from Crohn's treatment?
Melanoma risk associated with IBD regardless of therapy
Findings published February 7, 2014 in the journal Clinical Gastroenterology and Hepatology, found Crohn's disease and ulcerative colitis (UC) is associated with a 37 percent higher chance of the skin cancer, compared to the general population in a review 12 cohort studies.
The good news is if melanoma, which is the most dangerous form of skin cancer is treated early it is 100 percent curable.
The researchers from the Mayo Clinic, Minnesota wanted to find out if thiopurine therapy used to treat IBD raised risk of melanoma, suggested by past studies.
The researchers found no link between melanoma and the use of biological therapies for Crohn's and colitis. However, the study did reveal IBD puts people at risk for the skin cancer that kills 12,000 men and women each year and is on the rise, even in younger people.
The study authors suggest patients with Crohn's disease or ulcerative colitis have a discussion with their doctors about their susceptibility for developing melanoma or any type of skin cancer, even those that are non-melanoma types.
Symptoms of skin cancer include:
- Any change in your skin, especially a mole or any new growth
- Scaling, oozing or bleeding
- A lesion that is itchy, tender or painful
- Melanoma is irregular, has uneven borders, has a variety of colors, continues to change and is larger than the size of a pencil eraser
Does Crohn's disease raise the risk of other types of skin cancer?
Checking your skin for other types of cancer is also important. A study conducted last year showed non-melanoma skin cancers could be a risk if you have Crohn's disease or colitis and have been treated with thiopurines. But the studies are inconclusive, making it confusing.
A recent study, published last month in The Journal of Gastroenterology that looked at eight studies involving 60,351 patients found only a "modest" risk of non-melanoma skin cancer associated with IBD treatment. with thiopurines. Examples include squamous and basal cell carcinoma.
Conversely, Associate Prof. Jess, who presented a different finding at the 2013 United European Gastroenterology week symposium said: "It is biologically plausible that thiopurine-treated IBD patients may be at increased risk of non-melanoma skin cancer, since these agents increase the sensitivity of DNA to damage caused by ultraviolet radiation from sunlight.
Jess also explained there are no guidelines specific for IBD patients for prevention of melanoma or non-melanoma type skin cancers, unlike organ transplant recipients who also receive immunosuppressive therapy and are advised to have annual skin examinations. Jess suggested it may be time to engage dermatologists in caring for those with Crohn's disease and UC.
Here is a video that shows how your doctor, ideally a dermatologist, should check for skin cancer that even form on the scalp, under the nail beds and other areas that are difficult to self-assess:
The take home message for anyone with Crohn's disease or ulcerative colitis is to check your own skin regularly and consider seeing a dermatologist annually. Crohn's disease can also affect the skin in other ways, making early diagnosis and treatment for any changes always the best policy. Follow recommendations used by the general population to use sunscreen, avoid tanning beds and use protective clothing when feasible. The newest finding suggests melanoma is a risk for IBD patients, regardless of biological therapy use.