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00; P ≤ 0.01), respectively. The risk of lymphoma associated with combination therapy was higher than with thiopurines or anti-TNF alone with pooled IRR of 1.70 (95% CI 1.03-2.81; P = 0.039) and 2.49 (95% CI 1.39-4.47; P = 0.002), respectively. The risk did not differ between anti-TNF monotherapy and thiopurine monotherapy with pooled IRR of 0.72 (95% CI 0.48-1.07; P = 0.107). All observational studies were of high quality according to the Newcastle-Ottawa scale. There is an increased risk of lymphoma in IBD patients treated with anti-TN