Cited by 295Inflammatory Bowel DiseaseColorectal Cancer Screening and DetectionMicroscopic Colitis

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Colorectal Cancer in Inflammatory Bowel Disease

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Higgins, Peter, Stidham, Ryan·2018·Clinics in Colon and Rectal Surgery

DOI 10.1055/s-0037-1602237PMC PMC5929884

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Abstract

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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Authors: Higgins, P., & Stidham, R.
Affiliations: University of Michigan (US)
ORCID: Higgins, Peter
Stidham, Ryan
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
DOI: 10.1055/s-0037-1602237
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: Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
Health Sciences › Medicine › Gastroenterology › 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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