Risk of Colorectal Cancer in Inflammatory Bowel Disease: Prevention and Monitoring Strategies According With Risk Factors

Abstract

Colorectal cancer (CRC) is slightly increased in inflammatory bowel disease (IBD) patients, with roughly a 2.5-fold increase compared to the general population. Clinical features associated to CRC risks are extent and severity of colonic involvement, disease duration, concomitant primary sclerosing cholangitis (PSC) and/or familial history of CRC in first-degree relatives. Colonic Crohn’s disease (CD) and ulcerative colitis (UC) share similar risks when similar colonic extent is affected. Risk stratification affects outcomes and surveillance programs.Newer endoscopic techniques substantially ameliorated diagnostic performance of endoscopy, and nowadays the standard for CRC surveillance in IBD patients is high-definition endoscopy, with dye-spray or virtual colonoscopy, oriented at targeted (+ random) colonic biopsies.Visible dysplastic lesions should be considered for endoscopic resection, while invisible dysplasia is still a mandatory proctocolectomy indication.Newer endoscopic interventional techniques (endoscopic mucosa resection, EMR, and endoscopic submucosal dissection, ESD) are appropriate therapeutic techniques to be delivered, but long-term risks of cancer should be balanced towards proctocolectomy.

An injectable subcutaneous colon-specific immune niche for the treatment of ulcerative colitis

“…However, traditional immunosuppressive drugs suppress the entire immune system, and increase the probability of infection and cancer development 14 . Studies have found that patients with ulcerative colitis are nearly 2.5 times more likely to develop colorectal cancer than the general population 60,61 . Therefore, developing new ulcerative colitis treatments is urgently needed.…”

An Injectable Subcutaneous Colon-Specific Immune Niche For The Treatment Of Ulcerative Colitis

“…Chronic colonic inflammation increases the risk of developing colorectal cancer 60, 61 . Therefore, we assessed whether combinational colon-specific immune niche could prevent the development of colitis-associated colorectal cancer in an established azoxymethane/dextran sulfate sodium model of colorectal cancer 62, 63 (Fig.…”