Skip to main content
SpringerLink
Log in

Chemoprevention in Ulcerative Colitis

  • Chapter
  • First Online:
Medical Therapy of Ulcerative Colitis

  • 1227 Accesses

Abstract

Colorectal cancer (CRC) is a feared complication of chronic ulcerative colitis (UC). The cumulative probability of developing colorectal cancer (CRC) among persons with UC is significantly higher than in the general population. UC is the third highest-risk condition for colorectal cancer after two genetic syndromes, familial adenomatous polyposis syndrome (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC). Data from a comprehensive meta-analysis suggest that the probability of CRC in IBD is 2 % after 10 years of disease, 8 % after 20 years, and 18 % after 30 years (Eaden et al., 48:526–535, 2001; Canavan et al., 23:1097–1104, 2006). In comparison, the cumulative lifetime probability of developing CRC for the general population in the United States is approximately 5 %.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ekbom A, Helmick C, Zack M, Adami HO. Ulcerative colitis and colorectal cancer. A population-based study. N Engl J Med. 1990;323(18):1228–33.

    Article  CAS  PubMed  Google Scholar 

  2. Clevers H. Colon cancer–understanding how NSAIDs work. N Engl J Med. 2006;354(7):761–3.

    Article  CAS  PubMed  Google Scholar 

  3. Eaden JA, Abrams KR, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut. 2001;48(4):526–35.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Canavan C, Abrams KR, Mayberry J. Meta-analysis: colorectal and small bowel cancer risk in patients with Crohn's disease. Aliment Pharmacol Ther. 2006;23(8):1097–104.

    Article  CAS  PubMed  Google Scholar 

  5. Winther KV, Jess T, Langholz E, Munkholm P, Binder V. Long-term risk of cancer in ulcerative colitis: a population-based cohort study from Copenhagen county. Clin Gastroenterol Hepatol. 2004;2(12):1088–95.

    Article  PubMed  Google Scholar 

  6. Jess T, Loftus Jr EV, Velayos FS, et al. Risk of intestinal cancer in inflammatory bowel disease: a population-based study from Olmsted county Minnesota. Gastroenterology. 2006;130(4):1039–46.

    Article  PubMed  Google Scholar 

  7. Rutter MD, Saunders BP, Wilkinson KH, et al. Thirty-year analysis of a colonoscopic surveillance program for neoplasia in ulcerative colitis. Gastroenterology. 2006;130(4):1030–8.

    Article  PubMed  Google Scholar 

  8. Soderlund S, Brandt L, Lapidus A, et al. Decreasing time-trends of colorectal cancer in a large cohort of patients with inflammatory bowel disease. Gastroenterology. 2009;136(5):1561–7. quiz 1818-1569.

    Article  PubMed  Google Scholar 

  9. Munkholm P. Review article: the incidence and prevalence of colorectal cancer in inflammatory bowel disease. Aliment Pharmacol Ther. 2003;18 Suppl 2:1–5.

    Article  PubMed  Google Scholar 

  10. Velayos FS, Terdiman JP, Walsh JM. Effect of 5-aminosalicylate use on colorectal cancer and dysplasia risk: a systematic review and metaanalysis of observational studies. Am J Gastroenterol. 2005;100(6):1345–53.

    Article  CAS  PubMed  Google Scholar 

  11. Itzkowitz SH, Present DH. Consensus conference: colorectal cancer screening and surveillance in inflammatory bowel disease. Inflamm Bowel Dis. 2005;11(3):314–21.

    Article  PubMed  Google Scholar 

  12. Velayos FS, Loftus Jr EV, Jess T, et al. Predictive and protective factors associated with colorectal cancer in ulcerative colitis: a case-control study. Gastroenterology. 2006;130(7):1941–9.

    Article  PubMed  Google Scholar 

  13. Rutter MD, Saunders BP, Wilkinson KH, et al. Cancer surveillance in longstanding ulcerative colitis: endoscopic appearances help predict cancer risk. Gut. 2004;53(12):1813–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Svartz M. The treatment of 124 cases of ulcerative colitis with salazopyrine and attempts of desensibilization in cases of hypersensitiveness to sulfa. Acta Med Scand. 1948;131 Suppl 206:465–72.

    CAS  PubMed  Google Scholar 

  15. Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987;317(26):1625–9.

    Article  CAS  PubMed  Google Scholar 

  16. Thun MJ, Namboodiri MM, Heath Jr CW. Aspirin use and reduced risk of fatal colon cancer. N Engl J Med. 1991;325(23):1593–6.

    Article  CAS  PubMed  Google Scholar 

  17. Greenberg ER, Baron JA, Freeman Jr DH, Mandel JS, Haile R. Reduced risk of large-bowel adenomas among aspirin users. The Polyp Prevention Study Group. J Natl Cancer Inst. 1993;85(11):912–6.

    Article  CAS  PubMed  Google Scholar 

  18. Allgayer H. Review article: mechanisms of action of mesalazine in preventing colorectal carcinoma in inflammatory bowel disease. Aliment Pharmacol Ther. 2003;18 Suppl 2:10–4.

    Article  CAS  PubMed  Google Scholar 

  19. Pinczowski D, Ekbom A, Baron J, Yuen J, Adami HO. Risk factors for colorectal cancer in patients with ulcerative colitis: a case-control study. Gastroenterology. 1994;107(1):117–20.

    CAS  PubMed  Google Scholar 

  20. Bernstein CN, Nugent Z, Blanchard JF. 5-aminosalicylate is not chemoprophylactic for colorectal cancer in IBD: a population based study. Am J Gastroenterol. 2011;106(4):731–6.

    Article  CAS  PubMed  Google Scholar 

  21. Carrat F, Seksik P, Bouvier A-M, et al. 255 Aminosalicylates, thiopurines and the risk of colorectal cancer in inflammatory bowel diseases: a case-control study nested in the CESAME cohort. Gastroenterology. 2010;138(5, Suppl 1):S-47.

    Article  Google Scholar 

  22. Rutter M, Saunders B, Wilkinson K, et al. Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis. Gastroenterology. 2004;126(2):451–9.

    Article  PubMed  Google Scholar 

  23. Sutherland L, Macdonald JK. Oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev. 2006;2, CD000544.

    PubMed  Google Scholar 

  24. Farraye FA, Odze RD, Eaden J, Itzkowitz SH. AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology. 2010;138(2):738–45.

    Article  PubMed  Google Scholar 

  25. Kandiel A, Fraser AG, Korelitz BI, Brensinger C, Lewis JD. Increased risk of lymphoma among inflammatory bowel disease patients treated with azathioprine and 6-mercaptopurine. Gut. 2005;54(8):1121–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Beaugerie L, Brousse N, Bouvier AM, et al. Excess risk of lymphoproliferative disorders (LPD) in inflammatory bowel diseases (IBD): interim results of the CESAME cohort. Gastroenterology. 2008;134(A):116–7.

    Google Scholar 

  27. Matula S, Croog V, Itzkowitz S, et al. Chemoprevention of colorectal neoplasia in ulcerative colitis: the effect of 6-mercaptopurine. Clin Gastroenterol Hepatol. 2005;3(10):1015–21.

    Article  CAS  PubMed  Google Scholar 

  28. Faubion Jr WA, Loftus Jr EV, Harmsen WS, Zinsmeister AR, Sandborn WJ. The natural history of corticosteroid therapy for inflammatory bowel disease: a population-based study. Gastroenterology. 2001;121(2):255–60.

    Article  CAS  PubMed  Google Scholar 

  29. Kornbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010;105(3):501–23. quiz 524.

    Article  PubMed  Google Scholar 

  30. Rutgeerts P, Sandborn WJ, Feagan BG, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2005;353(23):2462–76.

    Article  CAS  PubMed  Google Scholar 

  31. Lashner BA, Heidenreich PA, Su GL, Kane SV, Hanauer SB. Effect of folate supplementation on the incidence of dysplasia and cancer in chronic ulcerative colitis. A case-control study. Gastroenterology. 1989;97(2):255–9.

    CAS  PubMed  Google Scholar 

  32. Lashner BA, Provencher KS, Seidner DL, Knesebeck A, Brzezinski A. The effect of folic acid supplementation on the risk for cancer or dysplasia in ulcerative colitis. Gastroenterology. 1997;112(1):29–32.

    Article  CAS  PubMed  Google Scholar 

  33. Giovannucci E, Stampfer MJ, Colditz GA, et al. Multivitamin use, folate, and colon cancer in women in the Nurses' Health Study. Ann Intern Med. 1998;129(7):517–24.

    Article  CAS  PubMed  Google Scholar 

  34. Cole BF, Baron JA, Sandler RS, et al. Folic acid for the prevention of colorectal adenomas: a randomized clinical trial. JAMA. 2007;297(21):2351–9.

    Article  CAS  PubMed  Google Scholar 

  35. Lindor KD, Kowdley KV, Luketic VA, et al. High-dose ursodeoxycholic acid for the treatment of primary sclerosing cholangitis. Hepatology. 2009;50(3):808–14.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  36. Lindor KD. Ursodiol for primary sclerosing cholangitis. Mayo Primary Sclerosing Cholangitis-Ursodeoxycholic Acid Study Group. N Engl J Med. 1997;336(10):691–5.

    Article  CAS  PubMed  Google Scholar 

  37. Soetikno RM, Lin OS, Heidenreich PA, Young HS, Blackstone MO. Increased risk of colorectal neoplasia in patients with primary sclerosing cholangitis and ulcerative colitis: a meta-analysis. Gastrointest Endosc. 2002;56(1):48–54.

    Article  PubMed  Google Scholar 

  38. Farraye FA, Odze RD, Eaden J, Itzkowitz SH. AGA technical review on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology. 2010;138(2):746–74. 774 e741-744; quiz e712-743.

    Article  PubMed  Google Scholar 

  39. Tung BY, Emond MJ, Haggitt RC, et al. Ursodiol use is associated with lower prevalence of colonic neoplasia in patients with ulcerative colitis and primary sclerosing cholangitis. Ann Intern Med. 2001;134(2):89–95.

    Article  CAS  PubMed  Google Scholar 

  40. Pardi DS, Loftus Jr EV, Kremers WK, Keach J, Lindor KD. Ursodeoxycholic acid as a chemopreventive agent in patients with ulcerative colitis and primary sclerosing cholangitis. Gastroenterology. 2003;124(4):889–93.

    Article  CAS  PubMed  Google Scholar 

  41. Wolf JM, Rybicki LA, Lashner BA. The impact of ursodeoxycholic acid on cancer, dysplasia and mortality in ulcerative colitis patients with primary sclerosing cholangitis. Aliment Pharmacol Ther. 2005;22(9):783–8.

    Article  CAS  PubMed  Google Scholar 

  42. Eaton JE, Silveira MG, Pardi DS, et al. High-dose ursodeoxycholic acid is associated with the development of colorectal neoplasia in patients with ulcerative colitis and primary sclerosing cholangitis. Am J Gastroenterol. 2011;106(9):1638–45.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  43. Lindstrom L, Boberg KM, Wikman O, et al. High dose ursodeoxycholic acid in primary sclerosing cholangitis does not prevent colorectal neoplasia. Aliment Pharmacol Ther. 2012;35(4):451–7.

    Article  CAS  PubMed  Google Scholar 

  44. Chapman R, Fevery J, Kalloo A, et al. Diagnosis and management of primary sclerosing cholangitis. Hepatology. 2010;51(2):660–78.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology, University of California, San Francisco, 2330 Post St., Suite 610, San Francisco, CA, 94115, USA

    Fernando Velayos M.D., M.P.H.

Authors
  1. Fernando Velayos M.D., M.P.H.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fernando Velayos M.D., M.P.H. .

Editor information

Editors and Affiliations

  1. Gastroenterology Division, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA

    Gary R. Lichtenstein

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Velayos, F. (2014). Chemoprevention in Ulcerative Colitis. In: Lichtenstein, G. (eds) Medical Therapy of Ulcerative Colitis. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1677-1_26

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-1677-1_26

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1676-4

  • Online ISBN: 978-1-4939-1677-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation