Effects of Primary Sclerosing Cholangitis on Risks of Cancer and Death in People With Inflammatory Bowel Disease, Based on Sex, Race, and Age

Abstract

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The Role of microRNAs in Cholangiocarcinoma

“…A genetic study of 186 patients with PSC-biliary tract cancer showed eCCA with high genomic alterations in TP53 (35.5%), KRAS (28.0%), CDKN2A (14.5%), and SMAD4 (11.3%), and even in underlying druggable mutation genes, such as HER2 / ERBB2 [ 32 ]. Moreover, a 10-year nationwide population-based study from the UK suggested that development of PSC increases the risk of CCAs (hazard ratio [HR] = 28.46, p < 0.001) in patients with PSC-IBD, and it also increases the risk of HCC (HR = 21.00, p < 0.001), gallbladder cancer (HR = 9.19, p < 0.001), pancreatic cancer (HR = 5.26, p < 0.001), and colorectal cancer (HR = 2.43, p < 0.001) [ 33 ].…”

Neoplastic risk for liver and colon in primary sclerosing cholangitis

“…The high cancer risk in PSC is well established and cancer is the most common cause of death [1,4,10] . The risk is highest for bile duct cancer, but increased risks for hepatocellular carcinoma (HCC), pancreatic cancer, and colorectal cancer (CRC) are also reported [2,[11][12][13] . Cholangiocarcinoma (CCA) has an aggressive course and poor prognosis with a one-year mortality rate of up to 80% [14] .…”

Recurrent Primary Sclerosing Cholangitis: Current Understanding, Management, and Future Directions

“…23 Furthermore, there are additional risks of hepatocellular (HR: 21.00), gallbladder (HR: 9.19), and pancreatic carcinoma (HR: 5.26). 24 A cumulative 11 to 14% 10-year risk for colorectal cancer (CRC) exists in patients with PSC-IBD. 19,22 The risk of CRC is greatest in PSC-IBD patients with pancolitis.…”

“…24 Furthermore, the incidence of CRC among those diagnosed at age < 50 years old with PSC-IBD is fivefold greater versus those with IBD alone. 24 Thus, all patients with PSC should be assessed for concurrent IBD at initial diagnosis and those with colitis should undergo regular surveillance with annual colonoscopy. 2,26 Regular abdominal imaging to screen for gallbladder, biliary tree, and liver abnormalities is also recommended, especially in patients who develop symptom changes or worsening laboratory parameters.…”

“…25 Similarly, compared with IBD alone, PSC-IBD patients have a fourfold increased risk of CRC, along with a younger median age of CRC diagnosis (59 years; interquartile range [IQR]: 47-72 vs. 69 years; IQR: 58-78; p < 0.001). 24 Furthermore, the incidence of CRC among those diagnosed at age < 50 years old with PSC-IBD is fivefold greater versus those with IBD alone. 24 Thus, all patients with PSC should be assessed for concurrent IBD at initial diagnosis and those with colitis should undergo regular surveillance with annual colonoscopy.…”