Colorectal Carcinoma Complicating Inflammatory Bowel Disease

Introduction

The two forms of inflammatory bowel disease (IBD), Crohn's disease (CD) and ulcerative colitis (UC), are characterized by chronic, relapsing inflammation of the intestines. Patients with UC and CD of the colon are at an increased risk of developing colorectal cancer (CRC). Although only 1% of all cases of CRC occur in IBD patients, IBD patients represent a high-risk group for developing CRC. CRC accounts for approximately 10–15% of all deaths in IBD patients. The exact magnitude of the CRC risk has remained controversial in the past due to various biases and methodological errors in published studies. Strategies to reduce or prevent the complications associated with invasive cancer are essential in this high-risk population. Surveillance colonoscopies are therefore an important strategy to detect CRC and dysplasia at an early stage. This article will review the clinical characteristics of IBD-related CRC as well as the epidemiology as the evidence and rationale behind consensus guidelines for screening and surveillance.

Abstract

Patients with inflammatory bowel disease (IBD) are at increased risk for developing colorectal carcinoma (CRC). It accounts for approximately 10–15% of all deaths in IBD patients. The magnitude of the increased risk as well as how to mitigate it best remain a topic of ongoing investigation in the field. Strategies to reduce or prevent the complications associated with invasive cancer are essential in this high-risk population. Surveillance colonoscopies are an important strategy to detect CRC and dysplasia at an early stage and thereby decrease CRC-related morbidity and mortality. This article will review the clinical characteristics of IBD-related CRC as well as the epidemiology as the evidence and rationale behind consensus guidelines for screening and surveillance.

Keywords

Inflammatory Bowel Disease, colorectal carcinoma, dysplasia, epidemiology, surveillance colonoscopies, ulcerative colitis, Crohn's Disease