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Colorectal Cancer in Inflammatory Bowel Disease

  • V. Croog
  • S.H. Itzkowitz

Abstract

Patients with inflammatory bowel disease (IBD) affecting the colon are at increased risk of developing colorectal cancer (CRC) compared to the general population. Both duration and extent of colitis are important risk factors for CRC, as is the presence of primary sclerosing cholangitis (PSC), family history of CRC, and (in some studies) early age at diagnosis of colitis. Efforts to reduce this risk have focused on colonoscopic surveillance as the best alternative to the more definitive but less appealing approach of prophylactic colectomy. Though surveillance has benefits that probably include decreased CRC mortality, its efficacy has not been firmly established and is limited by problems of patient dropout, sampling error when too few biopsies are taken at endoscopy, and difficulty in histopathological interpretation of dysplasia. High false negative rates at endoscopy have led to the recommendation that colectomy be considered for dysplasia of any grade.

Keywords

Ulcerative Colitis Primary Sclerosing Cholangitis Inflammatory Bowel Disease Patient Total Proctocolectomy High False Negative Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Eaden JA, Abrams KR, Mayberry JF (2001) The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut 48:526–35.PubMedCrossRefGoogle Scholar
  2. 2.
    Ekbom A, Heimick C, Zack M, Adami HO (1990) Ulcerative colitis and colorectal cancer. A population-based study. N Engl J Med 323:1228–33.PubMedCrossRefGoogle Scholar
  3. 3.
    Bansal P, Sonnenberg A (1996) Risk factors of colorectal cancer in inflammatory bowel disease. Am J Gastroenterol 91:44–8.PubMedGoogle Scholar
  4. 4.
    Itzkowitz SH (1997) Inflammatory bowel disease and cancer. Gastroenterol Clin North Am 26:129–39.PubMedCrossRefGoogle Scholar
  5. 5.
    Bernstein CN, Shanahan F, Weinstein WM (1994) Are we telling patients the truth about surveillance colonoscopy in ulcerative colitis? [see comments]. Lancet 343:71–4.PubMedCrossRefGoogle Scholar
  6. 6.
    Rubin PH, Friedman S, Harpaz N, Goldstein E, Weiser J, Schiller J, Waye JD, Present DH (1999) Colonoscopic polypectomy in chronic colitis: conservative management after endoscopic resection of dysplastic polyps. Gastroenterology. 117:1295–300.PubMedCrossRefGoogle Scholar
  7. 7.
    Provenzale D, Kowdley KV, Arora S, Wong JB (1995) Prophylactic colectomy or surveillance for chronic ulcerative colitis? A decision analysis [see comments]. Gastroenterology 109:1188–96.PubMedCrossRefGoogle Scholar
  8. 8.
    Sagar P, Lewis W, Holdsworth P, Johnston D, Mitchell C, MacFie J (1993) Quality of life after restorative proctocolectomy with a pelvic ileal reservoir compares favorably with that of patients with medically treated colitis. Dis Colon Rectum 36:584–92.PubMedCrossRefGoogle Scholar
  9. 9.
    Ullman TA, Loftus, E.V.Jr, Kakar S, Burgart LJ, Sandborn WJ, Tremaine, WJ (2002) Fate of Low-Grade Dysplasia in Ulcerative Colitis. Am J Gastroenterol 97:922–7.PubMedCrossRefGoogle Scholar
  10. 10.
    Eaden J, Abrams K, Ekbom A, Jackson E, Mayberry J (2000) Colorectal cancer prevention in ulcerative colitis: a case-control study. Aliment Pharmacol Ther 14:145–53.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • V. Croog
    • 1
  • S.H. Itzkowitz
    • 1
  1. 1.The Dr. Henry D. Janowitz Division of GastroenterologyMount Sinai School of MedicineNew YorkUSA

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