Colorectal Cancer in Inflammatory Bowel Disease
Open accessAbstract
Patients with inflammatory bowel disease (IBD) are at significantly increased risk of colorectal cancer (CRC), principally resulting from the pro-neoplastic effects of chronic intestinal inflammation. Epidemiologic studies continue to highlight the increased risk of CRC in IBD. However, the incidence has declined over the past 30 years, attributed to both successful CRC-surveillance programs and improved control of mucosal inflammation. Risk factors that further increase the risk of IBD-related CRC include disease duration, extent and severity, the presence of inflammatory pseudopolyps, coexistent primary sclerosing cholangitis, and a family history of CRC. All major professional societies agree that IBD-CRC surveillance should occur more frequently than in the general population. Yet, guidelines and consensus statements differ on the surveillance schedule and preferred method of surveillance. Improved sensitivity to previously "invisible" flat dysplastic lesions using high definition and chromoendoscopy methods has resulted in many guidelines abandoning requirements for random untargeted biopsies of the colon. While colonic dysplasia remains a worrisome finding, and several clinical scenarios remain best addressed by total proctocolectomy due to concerns of synchronous undetected lesions and the unpredictable tempo of progression to malignancy, better detection techniques have also increased opportunities for endoscopic resection of dysplastic lesions that can be clearly delineated. Finally, the expanding armamentarium of medical options in IBD, including anti-tumor necrosis factor and anti-adhesion biologic therapies, have substantially improved our ability to control severe inflammation and likely reduce the risk of CRC over time.
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Comorbid psychological difficulties in IBD are associated with disease activity, flares, treatment response, and the necessity of surgical intervention.
“Indeed, comorbid psychological difficulties are associated with disease activity, flares, treatment response, and the necessity of surgical intervention [2,6,8,9,10,11,12,13,14,15].”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [2]
The passages on CRC risk and dysplasia management discuss inflammation, cancer surveillance, and surgical decisions, but not comorbid psychological difficulties. Searches for psychological difficulties, depression, anxiety, flares, and treatment response found no passage linking psychological difficulties to the outcomes claimed. (LLM, conf=0.75)
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Inflammatory polyps occur more frequently in inflammatory bowel disease than other colitis patients
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- Authors
- Higgins, P., & Stidham, R.
- Affiliations
- University of Michigan (US)
- Venue
- Clinics in Colon and Rectal Surgery
- Publisher
- Georg Thieme Verlag KG
- Published
- 2018-04-01
- Volume
- 31
- Issue
- 03
- Pages
- 168-178
- ISSN
- 1521-5741 (ISSN-L)
- 1531-0043
- 1530-9681
- PMC
- PMC5929884
- OpenAlex
- W2795176771
- Cited by
- 295
- References
- 93
- Citations by year
- 2026: 16 · 2025: 38 · 2024: 37 · 2023: 46 · 2022: 60 · 2021: 42 · 2020: 31 · 2019: 22 · 2018: 2
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinics in Colon and Rectal Surgery (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK101687)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Health Sciences › Medicine › Epidemiology › Microscopic Colitis
- Keywords
- inflammatory bowel disease, colorectal cancer, IBD-associated colorectal cancer, chronic intestinal inflammation, colorectal cancer surveillance, inflammatory pseudopolyps, primary sclerosing cholangitis, colonic dysplasia, chromoendoscopy, high-definition endoscopy, endoscopic resection, total proctocolectomy, anti-TNF therapy, disease duration
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