S3093 Cancer and Complication Risk in Non-Eosinophilic Esophagitis Eosinophilic GI Disorders: A Propensity Score-Matched Cohort Study

Introduction: Non-eosinophilic esophagitis gastrointestinal disorders (Non-EoE EGIDs), including eosinophilic gastroenteritis (EGE) and eosinophilic colitis (EC), are rare immune-mediated eosinophilic inflammatory diseases. Chronic inflammation is implicated in carcinogenesis, yet the long-term malignancy risk in Non-EoE EGIDs remains unclear. Methods: We performed a multicenter retrospective cohort study using the TriNetX electronic health records database. Adults (>18 years) diagnosed with EGE or EC constituted the study cohort, matched 1:1 with controls lacking these diagnoses. Exclusion criteria included prior gastrointestinal malignancy. Propensity score matching adjusted for demographics and comorbidities, including eosinophilic esophagitis, Helicobacter pylori gastritis, inflammatory bowel disease, connective tissue disease, infectious gastroenteritis, family history of gastrointestinal (GI) malignancy, obesity, alcohol, and tobacco use. Primary outcome was composite GI malignancy incidence; secondary outcomes included site-specific cancers and GI complications. Results: We performed a multicenter retrospective cohort study using the TriNetX electronic health records database. Adults (>18 years) diagnosed with EGE or EC constituted the study cohort, matched 1:1 with controls lacking these diagnoses. Exclusion criteria included prior gastrointestinal malignancy. Propensity score matching adjusted for demographics and comorbidities, including eosinophilic esophagitis, Helicobacter pylori gastritis, inflammatory bowel disease, connective tissue disease, infectious gastroenteritis, family history of GI malignancy, obesity, alcohol, and tobacco use. Primary outcome was composite GI malignancy incidence; secondary outcomes included site-specific cancers and GI complications. Conclusion: Non-EoE EGIDs, especially EGEs, are associated with a significantly increased risk of gastrointestinal malignancies and obstructive complications. These findings highlight the urgent need for further research to elucidate clinical outcomes and optimize management strategies in these rare but potentially high-risk disorders.