Intest Res.  2014 Jul;12(3):194-204. 10.5217/ir.2014.12.3.194.

Inflammatory Bowel Disease-related Colorectal Cancer in the Asia-Pacific Region: Past, Present, and Future

• Zhiqin W
• Palaniappan S
• Raja Ali R

• KMID: 2174378
• DOI: http://doi.org/10.5217/ir.2014.12.3.194

Abstract

Patients with inflammatory bowel disease (IBD) are at an increased risk of developing colorectal cancer (CRC), and key contributing factors include chronic colonic inflammation and the extent and duration of disease. This increase in risk is more likely to result from chronic inflammation of the colonic mucosa than from any clearly defined genetic predisposition. However, globally, the true magnitude of this risk is debatable, since results from different studies are heterogeneous in terms of geographical and methodological variables. The prevalence of IBD-related CRC in the Asia-Pacific region ranges from 0.3% to 1.8% and a recent study found that the cumulative incidence of IBD-related CRC is comparable to that in Western countries. However, the CRC mortality rate in the Asia-Pacific region is on the rise compared with that in Western countries, and a few Asian countries show particularly rapid upward trends in CRC incidence. Although our understanding of the molecular and clinical basis for IBD-related CRC has improved substantially, our means of prevention, endoscopic surveillance, chemoprevention, and prophylactic surgery remain modest at best. Furthermore, published data on IBD-related CRC in the Asia-Pacific region is lacking, and this review addresses many aspects including epidemiology, natural history, etiopathogenesis, morphology, and biological behaviors of IBD-related CRC and sporadic CRC in the Asia-Pacific region. In this review, we will also discuss the risk factors for CRC in IBD patients, endoscopic technology screening, and surveillance programs and management strategies for IBD-related CRC.

Keyword

Inflammatory bowel disease; Colorectal neoplasms; Asia-Pacific region

MeSH Terms

Asian Continental Ancestry Group
Chemoprevention
Colon
Colorectal Neoplasms*
Epidemiology
Genetic Predisposition to Disease
Humans
Incidence
Inflammation
Inflammatory Bowel Diseases
Mass Screening
Mortality
Mucous Membrane
Natural History
Prevalence
Risk Factors

Figure

• 

  Fig. 1 Simple schematic diagram for molecular mechanism in IBD-related colorectal cancer (CRC) and spontaneous CRC. IL, interleukin; TNF-α, tumor necrosis factor-α; IFN-γ, interferon-γ; APC, adenomatous polyposis coli.

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