Who and how to screen for cancer in at-risk inflammatory bowel disease patients

Expert Rev Gastroenterol Hepatol. 2015 Jun;9(6):731-46. doi: 10.1586/17474124.2015.1003208. Epub 2015 Jan 16.

Abstract

Inflammatory bowel diseases (IBDs) include both Crohn's disease and ulcerative colitis and both diseases are marked by inflammation within the gastrointestinal tract. Due to long-standing inflammation, IBD patients are at increased risk of colorectal cancer, especially patients with chronic inflammation, pancolitis, co-diagnosis of primary sclerosing cholangitis and a longer duration of disease. Small bowel inflammation places Crohn's patients at an increased risk of small bowel cancer. A higher risk of skin cancers, lymphomas and cervical abnormalities is also seen in IBD patients; this is likely related to both disease factors and the presence of immunosuppressive medication. This article reviews which patients are at an increased risk of IBD-associated or IBD treatment-associated cancers, when to begin screening and which screening methods are recommended.

Keywords: Crohn’s disease; IBD-associated cancer; biologics; colorectal cancer; inflammatory bowel disease; lymphoma; skin cancer; thiopurines; ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Colitis, Ulcerative / complications*
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / therapy
  • Crohn Disease / complications*
  • Crohn Disease / diagnosis
  • Crohn Disease / therapy
  • Early Detection of Cancer* / methods
  • Humans
  • Neoplasms / diagnosis*
  • Neoplasms / etiology*
  • Patient Selection
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Time Factors