Colorectal carcinoma and preceding fistula in Crohn's disease

Abstract

Colorectal carcinoma is frequently associated with the presence of longstanding anorectal fistula.

Systematic review with meta‐analysis: use of 5‐aminosalicylates and risk of colorectal neoplasia in patients with inflammatory bowel disease

“…Twenty‐one studies contributed data specific for UC, while only five studies for CD . The reduction in CRN risk associated with 5‐ASA use was 50% among UC patients (RR = 0.50, 95% CI: 0.38–0.64), but weaker and nonsignificant among patients with CD (RR = 0.76, 95% CI: 0.43–1.33) (Table ).…”

“…Twenty‐one studies evaluated the association of 5‐ASA with CRC risk, while five studies reported data for dysplasia. Exposure to 5‐ASA was significantly associated with a protective effect against both outcomes (cancer: RR = 0.58, 95% CI: 0.45–0.74, Figure ; dysplasia: RR = 0.54, 95% CI: 0.35–0.84, Figure ) (Table ).…”

“…28, 30, 32-34, 36-38, 41-43, 45-50, 52, 55, 56, 58 Twelve were population-based, 28-30, 35, 39-41, 45, 46, 49, 54, 55 while 19 were hospital-based studies. 31-34, 36-38, 42-44, 47, 48, 50-53, 56-58 Seventeen studies analysed patients with UC, 30-33, 36-38, 44, 47, 50-55, 57, 58 two studies had patients with CD, 43,48 and 12 studies included both UC and CD patients. 28, 29, 34, 35, 39-42, 45, 46, 49, 56 The number of CRN cases ranged between 4 and 364 among the studies, for a total of 2137 cases (of which 76% were colorectal cancers), while the mean age of patients ranged between 40 and 75 years.…”

“…those scoring ≥6 stars at Newcastle-Ottawa scale; n = 24), 28-30, 32-36, 38-40, 42-50, 52-55 5-ASA use was again associated with a significant reduction in the risk of developing CRN (RR = 0.61, 95% CI: 0.48-0.78; Table 2). Similarly, when only studies published in full-text form were included, [28][29][30][31][32][33][34][35][36][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] the results did not materially change (RR = 0.63, 95% CI: 0.51-0.79; n = 27). Finally, when the analysis was restricted to studies adequately controlled for potential confounders (at least for age, disease extent and duration), the number of eligible studies 28,34,36,39,42,45,50,52 was rather limited (n = 8), and the association became nonsignificant (RR = 0.66, 95% CI: 0.38-1.14; Table 2).…”

Activation of the mTORC1 and STAT3 pathways promotes the malignant transformation of colitis in mice

“…A cohort study showed that the severity of microscopic inflammation over time is an independent risk factor for developing advanced colorectal neoplasia among patients with longstanding ulcerative colitis (25). In addition, in Crohn's disease patients, perianal disease, bypasses and strictures may be sites of increased risk for neoplastic transformation (26,27). These findings indicate that, in IBD patients, chronic intestinal inflammation may be the leading cause of CAC.…”