Declining Risk of Colorectal Cancer in Inflammatory Bowel Disease

Lutgens, M. W. M. D.; Oijen, Martijn G.H. van; Heijden, Geert J. M. G. van der; Vleggaar, Frank P.; Siersema, Peter D.; Oldenburg, Bas

doi:10.1097/mib.0b013e31828029c0

Cited by 420 publications

(171 citation statements)

References 67 publications

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“…A true and reliable risk assessment has been difficult to achieve, however, as various factors may bias study results. However, according to more recent studies and meta-analyses, the risk of UCC appears to be lower than previously described and may even come close to that of the general population [6][7][8].…”

Section: Introductioncontrasting

confidence: 51%

“…Extensive disease of the colon is associated with an increased risk for CRC. Lutgens et al calculated the pooled standardized incidence ratio for CRC in patients with extensive disease to be 6.9 (95 % CI 1.9-11.9) for four populationbased series and 21.6 (95 % CI 15.0-31.0) for two referral center series [8]. Within our sub-group of IBD patients with neoplastic lesions, we found 80 % to have an E3 disease.…”

Section: Discussionmentioning

confidence: 77%

“…The quantum of risk, however, is controversial. Most recent studies and meta-analyses state the overall risk to be much lower than previously reported and in some cohorts, the risk is not elevated in comparison to the general population [7,8,27,28]. Herrinton et al described an annual incidence for CRC per 100,000 person-years of 75.0 for CD and 76.0 for UC in comparison to 47.1 in the control group [28].…”

Section: Discussionmentioning

confidence: 80%

“…Although controversially discussed there are data that some medical agents used in IBD, such as Mesalazin and Thiopurine, might prevent advanced neoplasia in patients with IBD [29]. Still, the risk of CRC in IBD is significantly higher in patients with an extensive disease and uncontrolled inflammation, a diagnosis of IBD at young age, and in patients with a long history of disease [8]. In the present study, we aimed at scrutinizing the rate of neoplasias in specimens of IBD patients who underwent proctocolectomy at our referral center in the recent past.…”

Section: Discussionmentioning

confidence: 95%

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Colorectal neoplasia in IBD—a single-center analysis of patients undergoing proctocolectomy

Meyer

Laubert

Sommer

et al. 2015

Int J Colorectal Dis

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Section: Introductioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 95%

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Colorectal neoplasia in IBD—a single-center analysis of patients undergoing proctocolectomy

Meyer

Laubert

Sommer

et al. 2015

Int J Colorectal Dis

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“…Similarly, the incidence of CRC and small bowel adenocarcinoma was not increased in a Hungarian population-based CD cohort: the cumulative risk for developing CRC after a disease duration of 20 years was 1.1% [42]. Lutgens et al [43] provided an updated CRC risk in UC- and CD-associated colitis with a strict selection of studies based on population type, censoring for colectomy and patients with noncolitis CD. They reported an overall decline of CRC risk in IBD based on the results of 9 recent population-based studies.…”

Section: The Risk Of Crc In Ibdmentioning

confidence: 99%

Colorectal Cancer in Patients with Inflammatory Bowel Disease: The True Impact of the Risk

Herszényi¹,

Barabás

Miheller³

et al. 2014

Dig Dis

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Patients with long-standing inflammatory bowel disease (IBD) have an increased risk of colorectal cancer (CRC). The association between IBD and CRC is well supported, but reported risk estimates vary widely. Although recent evidence from population-based studies reports a decline in risk, CRC accounts for 10-15% of all deaths in IBD. The potential causes of recent epidemiological trends and the real magnitude of risk of CRC in IBD are subjects of debate. The molecular pathway leading to CRC differs from the classic adenoma-to-CRC sequence. Chronic inflammation contributes to the development of low- and high-grade dysplasia which may further convert into CRC. Patients with a young age at onset, long-standing and extensive colitis with severe inflammatory burden, a family history of sporadic CRC, and concomitant primary sclerosing cholangitis are at greatest risk. The CRC risk in patients with colonic Crohn's disease is similar to that of ulcerative colitis. IBD-associated CRC can frequently be detected at late stages and at a younger age. The long-term prognosis of CRC may be poorer in patients with IBD than in those with sporadic CRC. Regular surveillance colonoscopies may permit earlier detection of CRC, with a corresponding improved prognosis. The interval between surveillance colonoscopies is dependent on each patient's personal risk profile.

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Ulcerative Colitis in Adults

Gros,

Kaplan

2023

JAMA

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ImportanceUlcerative colitis (UC) is a chronic inflammatory condition of the colon, with a prevalence exceeding 400 per 100 000 in North America. Individuals with UC have a lower life expectancy and are at increased risk for colectomy and colorectal cancer.ObservationsUC impairs quality of life secondary to inflammation of the colon causing chronic diarrhea and rectal bleeding. Extraintestinal manifestations, such as primary sclerosing cholangitis, occur in approximately 27% of patients with UC. People with UC require monitoring of symptoms and biomarkers of inflammation (eg, fecal calprotectin), and require colonoscopy at 8 years from diagnosis for surveillance of dysplasia. Risk stratification by disease location (eg, Montreal Classification) and disease activity (eg, Mayo Score) can guide management of UC. First-line therapy for induction and maintenance of remission of mild to moderate UC is 5-aminosalicylic acid. Moderate to severe UC may require oral corticosteroids for induction of remission as a bridge to medications that sustain remission (biologic monoclonal antibodies against tumor necrosis factor [eg, infliximab], α4β7 integrins [vedolizumab], and interleukin [IL] 12 and IL-23 [ustekinumab]) and oral small molecules that inhibit janus kinase (eg, tofacitinib) or modulate sphingosine-1-phosphate (ozanimod). Despite advances in medical therapies, the highest response to these treatments ranges from 30% to 60% in clinical trials. Within 5 years of diagnosis, approximately 20% of patients with UC are hospitalized and approximately 7% undergo colectomy. The risk of colorectal cancer after 20 years of disease duration is 4.5%, and people with UC have a 1.7-fold higher risk for colorectal cancer compared with the general population. Life expectancy in people with UC is approximately 80.5 years for females and 76.7 years for males, which is approximately 5 years shorter than people without UC.Conclusions and RelevanceUC affects approximately 400 of every 100 000 people in North America. An effective treatment for mild to moderate UC is 5-aminosalicylic acid, whereas moderate to severe UC can be treated with advanced therapies that target specific inflammation pathways, including monoclonal antibodies to tumor necrosis factor, α4β7 integrins, and IL-12 and IL-23 cytokines, as well as oral small molecule therapies targeting janus kinase or sphingosine-1-phosphate.

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Declining Risk of Colorectal Cancer in Inflammatory Bowel Disease

Cited by 420 publications

References 67 publications

Colorectal neoplasia in IBD—a single-center analysis of patients undergoing proctocolectomy

Colorectal neoplasia in IBD—a single-center analysis of patients undergoing proctocolectomy

Colorectal Cancer in Patients with Inflammatory Bowel Disease: The True Impact of the Risk

Ulcerative Colitis in Adults

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