In this review the risk of breast, ovarian, and
endometrial cancer and cervical and vulvovaginal (pre)malignant abnormalities in patients with
inflammatory bowel disease (IBD) with or without immune suppressive treatment will be discussed. So far, this has not been studied thoroughly and large studies taking into account diverse potential confounding factors are lacking. IBD per se has not been associated with development of
cervical cancer, yet patients with
Crohn's disease who
smoke, have a younger age at diagnosis or who use(d) thiopurines might be more at risk. Other immunosuppressive medication seems not to increase this risk, however, as evidence at this point is incomplete, physician awareness and prevention by lifestyle counseling, HPV vaccination and (intensified) screening are warranted. The risk for breast, endometrial, ovarian, and vulvovaginal
cancer in IBD patients appears to be comparable to the background population, although for
breast cancer this may even be decreasedin
Crohn's disease specifically. Immunosuppressive medication in general does not seem to alter this risk. Earlier and more frequent screening for
breast cancer than currently conducted in general nationwide screening programs is not recommended at this moment. Current literature suggests a much lower overall
malignancy recurrence rate in IBD patients than has been observed previously. More importantly, immune suppressive medication does not appear to increase the recurrence risk. Robust epidemiologic data on female genital tract
cancer are needed.