Relationship between clinical parameters and the colitis-colorectal cancer interval in a cohort of patients with colorectal cancer in inflammatory bowel disease

Brackmann, Stephan; Andersen, Solveig Norheim; Aamodt, Geir; Langmark, Frøydis; Clausen, O. P. F.; Aadland, E; Fausa, O; Rydning, Andreas; Vatn, Morten H.

doi:10.1080/00365520801977568

Cited by 82 publications

(61 citation statements)

References 77 publications

(84 reference statements)

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“…The largest screening studies have shown that 5-year screening can lead to benefits in ≤73% of subjects, yet to benefits in only 36% in the group of those who were not screened [60]. This result suggests that targeted screening helps reduce the incidence of cancerous ulcerative colitis.…”

Section: Screening For Colorectal Tumorsmentioning

confidence: 81%

Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China

Fang¹,

Zheng²,

Jiang

et al. 2014

Gastrointest Tumors

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Background: Colorectal cancer (CRC) is steadily increasing in China. Colorectal adenoma (CRA) is the most important precancerous disease of CRC. Screening for colorectal tumors can aid early diagnosis. Advances in endoscopic mucosal resection and endoscopic submucosal dissection can aid the early treatment of colorectal tumors. Furthermore, because of high risk of recurrence after removal of adenomas under endoscopy, factors contributing to recurrence, the follow-up mode and the interval established, and the feasibility of application and the time of various chemical preventions should be concerned. However, a relevant consensus on the screening, early diagnosis and treatment, and prevention of colorectal tumors in China is lacking. Summary: The consensus recommendations include epidemiology, pathology, screening, early diagnosis, endoscopic treatment, monitoring and follow-up, and chemoprevention of colorectal tumors in China. Key Message: This is the first consensus on the prevention, screening, early diagnosis and treatment of CRA and CRC in China based on evidence in the literature and on local data. Practical Implications: Through reviewing the literature, regional data and passing the consensus by an anonymous vote, gastroenterology experts from all over China launch the consensus recommendations in Shanghai. The incidence and mortality of CRC in China has increased, and the incidence or detection rate of CRA has increased rapidly. Screening for colorectal tumors should be performed at age 50-74 years. Preliminary screening should be undertaken to find persons at high risk, followed by colonoscopy. A screening cycle of 3 years is recommended for persistent interventions. Opportunistic screening is a mode suitable for the current healthcare system and national situation. Colonoscopy combined with pathological examination is the standard method for the diagnosis of colorectal tumors. CRA removal under endoscopy can prevent CRC to some extent, but CRA has an obvious recurrence trend. The follow-up interval after the removal or surgery of colorectal tumors should be different with lesions. Primary prevention of CRA includes improved diet with more fiber, supplements containing calcium and vitamin D, supplements containing folic acid for those with low hemoglobin levels, and cessation of tobacco smoking. Non-steroidal anti-inflammatory drugs and selective cyclooxygenase-2 inhibitors have been recognized to prevent recurrence after adenoma removal.

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Section: Screening For Colorectal Tumorsmentioning

confidence: 81%

Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China

Fang¹,

Zheng²,

Jiang

et al. 2014

Gastrointest Tumors

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“…A meta-analysis similarly supported this correlation and reported an odds ratio (OR) of 4.79 [8]. Data further suggest that patients with PSC are at particular risk for the early development of CRC [9]. For unclear reasons, CRC in patients with PSC is more likely to occur on the right side of the colon.…”

Section: Colorectal Cancer In Children With Ulcerative Colitismentioning

confidence: 53%

Inflammatory Bowel Disease and Neoplasia in Children

Rufo¹

2014

Dig Dis

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Advances in our understanding of the pathophysiology of ulcerative colitis and Crohn's disease have led to the widespread use of increasingly potent immunosuppressive therapies. This has greatly benefited the majority of patients with inflammatory bowel disease (IBD) and has resulted in improved overall clinical outcomes and quality of life. However, a growing body of data now indicates that long-term use of these agents may at the same time place patients at risk for a number of adverse effects, including colorectal and skin cancer, as well as lymphoma. Children and adolescents may be at particular cumulative risk for the development of these malignancies as a result of their young age at diagnosis, often increased disease extent and severity, and greater lifetime exposure to immunosuppressive agents. More recent epidemiologic studies are now identifying specific genetic and treatment-related factors that may place patients at increased risk for the development of IBD-related cancer. Improved understanding of these risk factors should contribute to a more rational approach to the pharmacologic management of children and young adults with IBD. Similarly, clinicians will be better able to counsel patients about the risks and benefits associated with specific therapies and develop improved monitoring guidelines to reduce the incidence of these rare but often severe oncologic complications.

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“…20 In fact, in a recent study on the relationship between IBD clinical parameters and colorectal cancer interval, disease activity seemed to have an effect on the colitis-colorectal cancer interval. 21 Moreover, Jess and colleagues in a meta-analysis that included six papers (some of the available data were several decades old) observed a linear rising trend of cumulative incidence of colorectal cancer until 25 years after CD diagnosis. 4 On the contrary, in our series, the risk rate for cancer occurrence was initially high at CD onset, and then it showed an irregular trend until 150 months when the risk rate curve begins to rise again.…”

Section: Discussionmentioning

confidence: 97%

Clinical Presentation and Diagnosis of Intestinal Adenocarcinoma in Crohn’s Disease: Analysis of Clinical Predictors and of the Life-Time Risk

Ruffolo

Scarpa

Polese

et al. 2010

Journal of Gastrointestinal Surgery

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In CD, rectal bleeding, the most common alarm symptom for intestinal cancer, is not useful for an early diagnosis. CD patients presenting with an older age and obstruction should be thoroughly investigated to rule out neoplastic lesions. There is probably no safe interval of CD where surveillance for intestinal cancer can be omitted. In the meantime, even in absence of active disease, all CD patients should undergo therapy with 5-ASA.

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Relationship between clinical parameters and the colitis-colorectal cancer interval in a cohort of patients with colorectal cancer in inflammatory bowel disease

Cited by 82 publications

References 77 publications

Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China

Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China

Inflammatory Bowel Disease and Neoplasia in Children

Clinical Presentation and Diagnosis of Intestinal Adenocarcinoma in Crohn’s Disease: Analysis of Clinical Predictors and of the Life-Time Risk

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