Aminosalicylate Therapy in the Prevention of Dysplasia and Colorectal Cancer in Ulcerative Colitis

Rubin, David T.; LoSavio, Andelka; Yadron, Nicole; Huo, Dezheng; Hanauer, Stephen B.

doi:10.1016/j.cgh.2006.08.014

Cited by 111 publications

(70 citation statements)

References 21 publications

(9 reference statements)

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“…The chemoprotective effect of mesalamine seems to be dose-dependent. A 5-ASA dose, equivalent to mesalamine of at least 1.2g/day provided the greatest risk reduction (72%-81%) [51,65].…”

Section: Protective Factors For Crc In Ibdmentioning

confidence: 99%

Relationship between clinical parameters and the colitis-colorectal cancer interval in a cohort of patients with colorectal cancer in inflammatory bowel disease

Brackmann

Andersen

Aamodt

et al. 2009

Scandinavian Journal of Gastroenterology

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“…The chemoprotective effect of mesalamine seems to be dose-dependent. A 5-ASA dose, equivalent to mesalamine of at least 1.2g/day provided the greatest risk reduction (72%-81%) [51,65].…”

Section: Protective Factors For Crc In Ibdmentioning

confidence: 99%

Relationship between clinical parameters and the colitis-colorectal cancer interval in a cohort of patients with colorectal cancer in inflammatory bowel disease

Brackmann

Andersen

Aamodt

et al. 2009

Scandinavian Journal of Gastroenterology

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“…Reports following the metaanalysis were also contradictory. Investigating 96 cases and matched controls, Rubin et al [90] found that aminosalicylate use of 1.2 g/d or more was associated with a 72% reduction in the odds of dysplasia/CRC (OR, 0.28; 95% CI, 0.09-0.85). A trend for dose response was also reported (P = 0.056).…”

Section: Chemoprevention In Ibd-is It Possible?mentioning

confidence: 99%

“…www.wjgnet.com Pinczowski et al [31] Case-control 298 Sulfasalazine > 3 mo OR CRC : 0.38 (95% CI, 0.2-0.69) patients administered sulfasalazine Moody et al [101] Case-control 175 Sulfasalazine < 6 mo 10-fold elevated risk in non-exposed patients (30% vs 3%) Eaden et al [40] Case-control 102 Sulfasalazine, mesalasine regular use OR CRC : 0.25 (95% CI, 0.13-0.48) in regular users Lindberg et al [102] Cohort study 143 Sulfasalazine > 6 mo Non-significant decrease of risk (34% vs 44%) Bernstein et al [87] Case-control 373 5-ASA Non-significant elevation of risk in patients exposed Rutter et al [29] Case-control 204 5-ASA Non-significant elevation of risk of dysplasia in patients exposed Rubin et al [90] Case-control 124 5-ASA > 1.2 g regular use OR CRC : 0.28 (95% CI, 0.09-0.85) in regular users the use of any 5-ASA compound was associated with a 75% decreased risk of CRC (95% CI, 0.13-0.48). Among all 5-ASA compounds, mesalamine use was associated with the greatest degree of protection, providing the most benefit at doses greater than 1.2 g/d (OR, 0.09; 95% CI, 0.03-0.28).…”

Section: Chemoprevention In Ibd-is It Possible?mentioning

confidence: 99%

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Lakatos¹,

Lakatos²

2008

WJG

368

245

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Since the first report of an inflammatory bowel disease (IBD) case associated with colorectal cancer (CRC) by Crohn and Rosenberg [1] , significant efforts have been made to elucidate this presumed association. Nowadays, the association between IBD and the increased risk for CRC is widely accepted. Although CRC, complicating ulcerative colitis and Crohn's disease, accounts only for 1%-2% of all cases of CRC in the general population, it is considered a serious complication of the disease and accounts for approximately 10%-15% of all deaths in IBD patients [2] . The age at diagnosis of CRC associated with IBD is 15-20 years earlier compared to sporadic cancers. In the meta-analysis by Eaden et al [3] , the average age at diagnosis was 43.2 years. Similarly, in a recent publication from Eastern Europe [4] , it was found to be 50.9 years, 10-15 years younger compared to sporadic CRC cases from the same area (62.2 years) [5] . According to US [6] and Canadian [7] publications, almost two-thirds of the affected patients were males, yet results are conflicting [4,8] . In addition, the frequency of multiple CRCs is higher than in patients with sporadic CRC [9] .The increased risk of CRC in UC is almost a universal finding [3,[10][11][12][13] , yet the extent of this risk varies considerably with differences in study design and geographic area. The initial reports were published by tertiary gastroenterology centers, thus the high risk detected might have been a consequence of referral bias and overinterpretation due to the high percentage of extensive and chronically active cases in these cohorts. Results of population-based studies are more reliable; however, several geographical and ethnic differences have been noted.The report of the meta-analysis by Eaden et al [3] in 2001 was one of several milestones in this subject. The incidence of UC-associated CRC was estimated based on 116 articles involving 54 478 patients in whom 1698 CRC cases were detected. This was a mixture of referral center-based, hospital-based, and population-based studies of variable methodological qualities and levels of detail. The reported incidence was higher in the US AbstractThe risk of colorectal cancer for any patient with ulcerative colitis is known to be elevated, and is estimated to be 2% after 10 years, 8% after 20 years and 18% after 30 years of disease. Risk factors for cancer include extent and duration of ulcerative colitis, primary sclerosing cholangitis, a family history of sporadic colorectal cancer, severity of histologic bowel inflammation, and in some studies, young age at onset of colitis. In this review, the authors discuss recent epidemiological trends and causes for the observed changes. Population-based studies published within the past 5 years suggest that this risk has decreased over time, despite the low frequency of colectomies. The crude annual incidence rate of colorectal cancer in ulcerative colitis ranges from approximately 0.06% to 0.16% with a relative risk of 1.0-2.75. The exact mechanism for this chang...

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“…We hypothesize that this pattern of regression may be due in some degree to waxing and waning edema in the setting of lymphatic involvement, and perhaps also because of mesalamine use, a 5-ASA compound. 5-ASA medications are a common drug class used for maintenance of remission in inflammatory bowel disease (IBD), mainly ulcerative colitis, and epidemiological studies suggest that long-term consumption decreases the colon cancer risk for these patients (12,13). Furthermore, 5-ASA compounds have been demonstrated to have pro-apopotic and antiproliferative effects on several cancer-derived cell lines through a multitude of mechanisms including EGFR activation, COX-2 expression, and inhibition of Wnt/ β-catenin pathway (14)(15)(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

Radiographic and endoscopic regression of metastatic gastric cancer to the colon in the setting of 5-aminosalicylic acid use

Patel

McCall

Zhang

et al. 2016

J. Gastrointest. Oncol.

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Colonic metastases from gastric cancer are a rare phenomenon and sparsely reported in the literature. We report a case of a 59-year-old woman who presented with vague abdominal symptoms and initial computer tomography (CT) imaging suggestive of a colonic apple-core lesion with serial colonoscopic biopsies diagnostic of metastatic signet ring cell gastric adenocarcinoma. This case is unique given the evolving CT and endoscopic findings that suggested a regression in colonic wall thickening in the setting of 5-aminosalicylic acid (5-ASA) use prior to histologic diagnosis.

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Aminosalicylate Therapy in the Prevention of Dysplasia and Colorectal Cancer in Ulcerative Colitis

Cited by 111 publications

References 21 publications

Relationship between clinical parameters and the colitis-colorectal cancer interval in a cohort of patients with colorectal cancer in inflammatory bowel disease

Relationship between clinical parameters and the colitis-colorectal cancer interval in a cohort of patients with colorectal cancer in inflammatory bowel disease

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Radiographic and endoscopic regression of metastatic gastric cancer to the colon in the setting of 5-aminosalicylic acid use

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