Gut Liver.  2008 Sep;2(2):61-73.

Colorectal Cancer in Inflammatory Bowel Disease

• Potack J
• Itzkowitz

Abstract

Patients with long-standing inflammatory bowel disease have an increased risk of developing colorectal cancer (CRC). CRC risk increases with longer duration of colitis, greater anatomic extent of colitis, the presence of primary sclerosing cholangitis, family history of CRC and severity of inflammation of the colon. Chemoprevention includes aminosalicylates, ursodeoxycholic acid, and possibly folic acid. To reduce CRC mortality in IBD, colonoscopic surveillance remains the major way to detect early mucosal dysplasia. When dysplasia is confirmed, proctocolectomy is considered for these patients. Ulcerative colitis patients with total proctocolectomy and ileal pouch anal-anastomosis have a rather low risk of dysplasia in the ileal pouch, but the anal transition zone should be monitored periodically. New endoscopic and molecular screening approaches may further refine our current surveillance guidelines and our understanding of the natural history of dysplasia.

Keyword

Inflammatory bowel disease; Dysplasia; Colorectal neoplasms

MeSH Terms

Chemoprevention
Cholangitis, Sclerosing
Colitis
Colitis, Ulcerative
Colon
Colorectal Neoplasms
Folic Acid
Humans
Inflammation
Inflammatory Bowel Diseases
Mass Screening
Natural History
Ursodeoxycholic Acid
Cholangitis, Sclerosing
Folic Acid
Ursodeoxycholic Acid