Inflammatory bowel disease associated neoplasia: A surgeon's perspective

World J Gastroenterol. 2016 Jan 21;22(3):961-73. doi: 10.3748/wjg.v22.i3.961.

Abstract

Inflammatory bowel disease (IBD) is associated with increased risk of colorectal cancer (CRC). The risk is known to increase with longer duration of the disease, family history of CRC, and history of primary sclerosing cholangitis. The diagnosis of the neoplastic changes associated with IBD is difficult owing to the heterogeneous endoscopic appearance and inter-observer variability of the pathological diagnosis. Screening and surveillance guidelines have been established which aim for early detection of neoplasia. Several surgical options are available for the treatment of IBD-associated neoplasia. Patients' morbidities, risk factors for CRC, degree and the extent of neoplasia must be considered in choosing the surgical treatment. A multidisciplinary team including the surgeon, gastroenterologist, pathologist, and the patient who has a clear understanding of the nature of their disease is needed to optimize outcomes.

Keywords: Colectomy; Colorectal cancer; Dysplasia; Endoscopy; Inflammatory bowel disease; Surveillance.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Colectomy / adverse effects
  • Colectomy / methods*
  • Colonoscopy* / adverse effects
  • Colorectal Neoplasms / diagnostic imaging
  • Colorectal Neoplasms / etiology
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Early Detection of Cancer
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / diagnosis
  • Inflammatory Bowel Diseases / drug therapy
  • Neoplasm Staging
  • Postoperative Complications / etiology
  • Predictive Value of Tests
  • Risk Factors
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Gastrointestinal Agents