High frequency of early colorectal cancer in inflammatory bowel disease.

[Guest guest]

Gut 57: 1246-1251 (2008)

High frequency of early colorectal cancer in inflammatory bowel

disease.

M W M D Lutgens, F P Vleggaar, M E I Schipper, P C F Stokkers, C J

van der Woude, D W Hommes, D J de Jong, G Dijkstra, A A van

Bodegraven, B Oldenburg, M Samsom

http://gut.bmj.com/cgi/content/full/57/9/1246

" IBD-associated colorectal carcinogenesis is characterised by

an " inflammation–dysplasia–carcinoma " sequence3 which differs from

the " adenoma–carcinoma " sequence in sporadic CRC. High-grade or

multifocal low-grade dysplasia indicate that the entire mucosal

lining of the colon, exposed to chronic inflammation, is at increased

risk of developing cancer,3 4 thereby heralding the rigorous advice

of proctocolectomy. In order to prevent development of CRC, IBD

patients are advised to undergo colonic surveillance aimed at

detection of dysplasia or asymptomatic early CRC at a surgically

curable stage. Currently, the surveillance guidelines followed most

often are those defined by the American Gastroenterological

Association (AGA)5 and the British Society for Gastroenterology

(BSG).6 "

" Patients with primary sclerosing cholangitis (including those with

an orthotropic liver transplant) represent a subgroup at higher risk

of cancer and they should have annual colonoscopy "

Dave

(father of (23); PSC 07/03; UC 08/03)