Clinicians may be hesitant to prescribe biologics or immunomodulators to individuals with familial adenomatous polyposis (FAP) and comorbid inflammatory disease (CID) because of increased cancer risk. Our aim was to compare the risk of malignancy in FAP individuals with inflammatory bowel (IBD) and/or rheumatic disease that received biologics/immunomodulators to those who did not. Individuals with FAP and CID were included in the study. We compared the incidence of cancer between individuals exposed to biologics/immunomodulators compared to unexposed from the date of diagnosis of comorbid disease till last follow up or death. Hazard ratio (HR) for cancer was computed using Cox regression model and compared by exposure status to biologic/immunomodulators. 25 individuals with FAP and a comorbid inflammatory disease were identified including 9 (36%) with IBD and 16 (64%) with rheumatic disease. 14 (56%) were exposed to a biologic and or immunomodulator. Median duration of biologic/immunomodulator exposure was 48 (2–180) months. 3 (21.4%) in the exposed group compared to 1 (9.1%) in the unexposed group developed cancer with a HR for exposure of 1.92 (CI 0.2–18.5, p = 0.57). Median duration of follow up after the diagnosis of inflammatory disease was 10 (5.5–17.0) years in the exposed and 6 (3.0–15.0) years in the unexposed group. In the exposed group, 1 patient developed gastric and 2 developed colon cancer. One unexposed patient developed medullary thyroid cancer. There is a possible trend of more cancers in the group that received biologics/immunomodulators—but given the small number of patients and p-value, there may be no difference at all. This preliminary finding warrants study in a larger cohort.

由于癌症风险增加，临床医生可能不愿为患有家族性腺瘤性息肉病 (FAP) 和合并炎症性疾病 (CID) 的个体开具生物制剂或免疫调节剂。我们的目的是比较接受生物制剂/免疫调节剂的 FAP 个体与未接受生物制剂/免疫调节剂的炎症性肠 (IBD) 和/或风湿性疾病患者的恶性肿瘤风险。患有 FAP 和 CID 的个体被纳入研究。我们比较了暴露于生物制剂/免疫调节剂的个体与从共病诊断日期到最后一次随访或死亡未暴露的个体之间的癌症发病率。使用 Cox 回归模型计算癌症的风险比 (HR)，并通过对生物/免疫调节剂的暴露状态进行比较。确定了 25 名 FAP 和合并炎症性疾病患者，其中 9 名 (36%) 患有 IBD，16 名 (64%) 患有风湿性疾病。14 (56%) 人暴露于生物和/或免疫调节剂。生物/免疫调节剂暴露的中位持续时间为 48 (2-180) 个月。暴露组中有 3 人 (21.4%) 与未暴露组中有 1 人 (9.1%) 发生癌症，暴露的 HR 为 1.92 (CI 0.2–18.5, p = 0.57)。炎症性疾病诊断后的中位随访时间为暴露组 10 (5.5-17.0) 年和未暴露组 6 (3.0-15.0) 年。在暴露组中，1名患者发展为胃癌，2名患者发展为结肠癌。一名未暴露的患者患上了甲状腺髓样癌。p值，可能根本没有区别。这一初步发现值得在更大的队列中进行研究。