Gut Liver.
2022 Nov;16(6):840-848. 10.5009/gnl210479.
Chemoprevention of Colitis-Associated Dysplasia or Cancer in Inflammatory Bowel Disease
- Affiliations
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- 1Division of Gastroenterology, Changhua Christian Hospital, Taiwan
- 2Division of Gastroenterology, Yuanlin Christian Hospital, Taiwan
- 3General Education Center, Chienkuo Technology University, Changhua, Taiwan
- 4Department of Electrical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan
- 5Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- 6Department of Hospitality Management, MingDao University, Changhua, Taiwan
- KMID: 2535188
- DOI: http://doi.org/10.5009/gnl210479
Abstract
- The association between inflammatory bowel disease and colorectal cancer is well known. Although the overall incidence of inflammatory bowel disease has declined recently, patients with this disease still have a 1.7-fold increased risk of colorectal cancer. The risk factors for developing colorectal cancer include extensive colitis, young age at diagnosis, disease duration, primary sclerosing cholangitis, chronic colonic mucosal inflammation, dysplasia lesion, and post-inflammatory polyps. In patients with inflammatory bowel disease, control of chronic inflammation and surveillance colonoscopies are important for the prevention of colorectal cancer. The 2017 guidelines from the European Crohn’s and Colitis Organisation suggest that colonoscopies to screen for colorectal cancer should be performed when inflammatory bowel disease symptoms have lasted for 8 years. Current evidence supports the use of chemoprevention therapy with mesalamine to reduce the risk of colorectal cancer in patients with ulcerative colitis. Other compounds, including thiopurine, folic acid, statin, and tumor necrosis factor-α inhibitor, are controversial. Large surveillance cohort studies with longer follow-up duration are needed to evaluate the impact of drugs on colorectal cancer risks.
