title: Primary sclerosing cholangitis as an independent risk factor for colorectal cancer in the context of inflammatory bowel disease: a review of the literature.
abstract: To examine and evaluate recent evidence regarding the epidemiology, pathogenesis and management of colorectal cancer (CRC) development in inflammatory bowel disease (IBD)-primary sclerosing cholangitis (PSC) patients. Using the PubMed database, a literature search was conducted for relevant articles in English from the past 10 years. Relevant studies investigating PSC as a risk factor for CRC in IBD in the context of incidence and prevalence, pathogenesis, prevention and prognosis were included in this review. Recent evidence increasingly points to PSC as a significant risk factor in the development of CRC in patients with concomitant IBD. PSC may be an important risk factor for CRC in different populations worldwide. The mechanism for this increase in risk is still unclear. The efficacy of UDCA as a chemopreventive agent remains controversial. Liver transplantation does not halt the development of CRC, although there is not enough evidence to suggest that it is associated with increased incidence of CRC. While routine colonoscopic surveillance should be performed in patients with concurrent PSC and IBD, more high-level evidence is required to support the benefits of the procedure. While many new developments have taken place in the last decade, the pathogenesis and optimal management of CRC development in IBD-PSC patients remain unclear.
authors.affiliation: Rosy Wang, Rupert W Leong, Gastroenterology and Liver Services, Concord Hospital, Sydney, Concord NSW 2139, Australia.
authors.forename: Rosy
authors.initials: R
authors.lastname: Wang
authors.affiliation: Rosy Wang, Rupert W Leong, Gastroenterology and Liver Services, Concord Hospital, Sydney, Concord NSW 2139, Australia.
authors.forename: Rupert W
authors.initials: RW
authors.lastname: Leong
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016588:Anticarcinogenic Agents / Q000627:therapeutic use; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D015209:Cholangitis, Sclerosing / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D016588:Anticarcinogenic Agents; D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid
keywords: Colorectal cancer; Crohn’s; Inflammatory bowel disease; Liver transplantation; Primary sclerosing cholangitis; Ulcerative colitis; Ursodeoxycholic acid
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