Access barriers and ethical challenges of therapeutic decision-making in patients with inflammatory bowel disease and prior malignancy: a case series

• Autores: Leandro Medeiros, Larissa, Queiroz Souza, Thales, Cronemberger de Faria, Maria Luiza, Jacarandá de Faria, Ricardo, Barrio Bortoli, Zuleica, Benvindo Lopes, Ana Carolina, Alves Martins, Bruno Augusto, de Vasconcelos Carneiro, Marcos, Cardozo Jorge, Caio
• Formato: artículo
• Fecha de Publicación: 2026
• Institución: Sociedad de Gastroenterología del Perú
• Repositorio: Revista de Gastroenterología del Perú
• Lenguaje: inglés
• OAI Identifier: oai:ojs.revistagastroperu.com:article/2047
• Enlace del recurso: https://revistagastroperu.com/index.php/rgp/article/view/2047
• Nivel de acceso: acceso abierto
• Materia: Inflammatory Bowel Diseases; Neoplasms; Unified Health System; Bioethics

Objectives: To report a case series of patients with inflammatory bowel diseases and a history of malignancy and to analyze how this condition influenced therapeutic decisionmaking presents a challenging scenario. Materials and methods: This was a retrospective observational study analyzing 11 patients with inflammatory bowel disease and malignant neoplasms followed at an inflammatory bowel disease outpatient clinic of a university hospital. Clinical, therapeutic, and oncologic findings are reported descriptively based on medical record review. Results: Seven patients (64%) had ulcerative colitis, and six (55%) were female, with a mean age of 47 years. Extra-intestinal neoplasms predominated. Six patients (55%) received advanced therapy near the time of cancer diagnosis; reintroduction was possible in four cases. Judicial action was required for two patients. Conclusions: Clinical decision-making in patients with inflammatory bowel disease and a history of malignancy is an individualized process, based on multidisciplinary discussion, bioethical considerations, and the most reliable available evidence, even in the face of state-imposed logistical obstacles. Continuous updating of Clinical Protocols and Therapeutic Guidelines is essential to ensure equitable access to the most appropriate and non-harmful treatment for this patient group.