title: Colorectal Cancer in Patients With Inflammatory Bowel Disease: The Need for a Real Surveillance Program.
abstract: The association between inflammatory bowel disease (IBD) and colorectal cancer (CRC) has been widely shown. This association is responsible for 10% to 15% of deaths in patients with IBD, even if according to some studies, the risk of developing CRC seems to be decreased. An adequate surveillance of patients identified as at-risk patients, might improve the management of IBD-CRC risk. In this article we review the literature data related to IBD-CRC, analyze potential risk factors such as severity of inflammation, duration, and extent of IBD, age at diagnosis, sex, family history of sporadic CRC, and coexistent primary sclerosing cholangitis, and update epidemiology on the basis of new studies. Confirmed risk factors for IBD-CRC are severity, extent, and duration of colitis, the presence of coexistent primary sclerosing cholangitis, and a family history of CRC. Current evidence-based guidelines recommend surveillance colonoscopy for patients with colitis 8 to 10 years after diagnosis, further surveillance is decided on the basis of patient risk factors. The classic white light endoscopy, with random biopsies, is now considered unsatisfactory. The evolution of technology has led to the development of new techniques that promise to increase the effectiveness of the monitoring programs. Chromoendoscopy has already proved highly effective and several guidelines suggest its use with a target biopsy. Confocal endomicroscopy and autofluorescence imaging are currently being tested and for this reason they have not yet been considered as useful in surveillance programs.
authors.affiliation: Department of Surgery, University of Genoa, IRCCS San Martino Hospital IST, Genova, Italy. Electronic address: rfornaro@unige.it.
authors.forename: Rosario
authors.initials: R
authors.lastname: Fornaro
authors.affiliation: Department of Surgery, University of Genoa, IRCCS San Martino Hospital IST, Genova, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Caratto
authors.affiliation: Department of Surgery, University of Genoa, IRCCS San Martino Hospital IST, Genova, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Caratto
authors.affiliation: Department of Surgery, University of Genoa, IRCCS San Martino Hospital IST, Genova, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Caristo
authors.affiliation: Department of Surgery, University of Genoa, IRCCS San Martino Hospital IST, Genova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fornaro
authors.affiliation: Department of Surgery, University of Genoa, IRCCS San Martino Hospital IST, Genova, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Giovinazzo
authors.affiliation: ARS-Agenzia Regionale Sanitaria, Liguria-Area Epidemiologia e Prevenzione, Genova, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Sticchi
authors.affiliation: Department of Surgery, University of Genoa, IRCCS San Martino Hospital IST, Genova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Casaccia
authors.affiliation: Department of Surgery, University of Genoa, IRCCS San Martino Hospital IST, Genova, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Andorno
mesh_terms: D015179:Colorectal Neoplasms / Q000209:etiology*; D055088:Early Detection of Cancer / Q000379:methods*; D062665:Epidemiological Monitoring; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008403:Mass Screening / Q000379:methods*; D012307:Risk Factors
keywords: Colorectal cancer; Crohn's disease; Endoscopy; Inflammatory bowel disease; Surveillance; Ulcerative colitis