BACKGROUND & AIMS Exposure to hormone contraception has been associated with an increased risk of relapse of inflammatory bowel diseases (IBDs). Little is known about the effects of cancer therapies, specifically hormone therapies, on the course of IBD. METHODS We conducted a retrospective cohort study, collecting data from 5 medical centers, on patients with IBD who received a subsequent diagnosis of breast or prostate cancer from 1997 through 2018. For patients with quiescent IBD at their cancer diagnosis, the primary outcome was relapse of IBD. For patients with active IBD at their cancer diagnosis, the primary outcome was IBD remission. RESULTS Our analysis included 447 patients with IBD (44% with Crohn's disease, 53% with ulcerative colitis, and 3% with IBD unclassified) who had either breast (78%) or prostate (22%) cancer. At their cancer diagnosis, 400 patients (90%) had inactive IBD, and 47 (10%) had active IBD. Among patients with inactive IBD, 112 (28%) developed active IBD. Previous exposure to steroids, immunomodulators, or biologics was associated with IBD relapse after a cancer diagnosis (hazard ratio [HR] for steroids, 1.79; 95% CI, 1.18-2.71; HR for immunomodulators, 2.22; 95% CI, 1.38-3.55; HR for biologics, 1.95; 95% CI, 1.01-5.36). Hormone monotherapy (HR, 2.00; 95% CI, 1.21-3.29) and combination cytotoxic and hormone therapy (HR, 1.86; 95% CI, 1.01-3.43) was associated with IBD relapse. Among 34 patients who received only cytotoxic chemotherapy, 75% remained in remission from IBD at 250 months compared with 42% of those who received hormone monotherapy (log rank, 0.02). Among patients with active IBD at their cancer diagnosis, 14 (30%) entered remission from IBD, but there were no significant factors of achieving IBD remission. CONCLUSIONS In a multicenter retrospective study, we found that patients with IBD and breast or prostate cancer who receive hormone therapy have an increased risk for relapse of IBD and related adverse outcomes.

中文翻译：

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癌症激素治疗是炎症性肠病复发的危险因素。

背景与目的 接受激素避孕与炎症性肠病 (IBD) 复发风险增加相关。关于癌症疗法（特别是激素疗法）对 IBD 病程的影响知之甚少。方法 我们进行了一项回顾性队列研究，收集了来自 5 个医疗中心的数据，研究对象为 1997 年至 2018 年期间随后被诊断为乳腺癌或前列腺癌的 IBD 患者。对于癌症诊断时处于静止状态的 IBD 患者，主要结局是复发炎症性肠病。对于癌症诊断时患有活动性 IBD 的患者，主要结局是 IBD 缓解。结果 我们的分析包括 447 名 IBD 患者（44% 患有克罗恩病，53% 患有溃疡性结肠炎，3% 患有未分类的 IBD），他们患有乳腺癌 (78%) 或前列腺癌 (22%)。在癌症诊断时，400 名患者 (90%) 患有非活动性 IBD，47 名患者 (10%) 患有活动性 IBD。在非活动性 IBD 患者中，112 名 (28%) 发展为活动性 IBD。既往接触类固醇、免疫调节剂或生物制剂与癌症诊断后 IBD 复发相关（类固醇的风险比 [HR]，1.79；95% CI，1.18-2.71；免疫调节剂的 HR，2.22；95% CI，1.38-3.55） ；生物制剂的 HR，1.95；95% CI，1.01-5.36）。激素单一疗法（HR，2.00；95% CI，1.21-3.29）以及细胞毒和激素联合疗法（HR，1.86；95% CI，1.01-3.43）与 IBD 复发相关。在 34 名仅接受细胞毒性化疗的患者中，75% 的患者在 250 个月时 IBD 仍处于缓解状态，而接受激素单一疗法的患者中这一比例为 42%（对数等级，0.02）。在癌症诊断时患有活动性 IBD 的患者中，14 名 (30%) 进入 IBD 缓解期，但没有实现 IBD 缓解的显着因素。结论 在一项多中心回顾性研究中，我们发现接受激素治疗的 IBD 合并乳腺癌或前列腺癌患者 IBD 复发和相关不良后果的风险增加。