Ulcerative colitis-associated colorectal cancer

doi:10.3748/wjg.v20.i44.16389

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Nov 28, 2014; 20(44): 16389-16397
Published online Nov 28, 2014. doi: 10.3748/wjg.v20.i44.16389

Ulcerative colitis-associated colorectal cancer

Masakazu Yashiro

Masakazu Yashiro, Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan

Masakazu Yashiro, Oncology Institute of Geriatrics and Medical Science, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan

Author contributions: Yashiro M solely contributed to the manuscript.

Correspondence to: Masakazu Yashiro, MD, PhD, Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. m9312510@med.osaka-cu.ac.jp

Telephone: +81-6-66453838 Fax: +81-6-66466450

Received: May 27, 2014
Revised: September 15, 2014
Accepted: October 14, 2014
Published online: November 28, 2014
Processing time: 188 Days and 16.6 Hours

Abstract

The association between ulcerative colitis (UC) and colorectal cancer (CRC) has been acknowledged. One of the most serious and life threatening consequences of UC is the development of CRC (UC-CRC). UC-CRC patients are younger, more frequently have multiple cancerous lesions, and histologically show mucinous or signet ring cell carcinomas. The risk of CRC begins to increase 8 or 10 years after the diagnosis of UC. Risk factors for CRC with UC patients include young age at diagnosis, longer duration, greater anatomical extent of colonic involvement, the degree of inflammation, family history of CRC, and presence of primary sclerosing cholangitis. CRC on the ground of UC develop from non-dysplastic mucosa to indefinite dysplasia, low-grade dysplasia, high-grade dysplasia and finally to invasive adenocarcinoma. Colonoscopy surveillance programs are recommended to reduce the risk of CRC and mortality in UC. Genetic alterations might play a role in the development of UC-CRC. 5-aminosalicylates might represent a favorable therapeutic option for chemoprevention of CRC.

Keywords: Ulcerative colitis-associated colorectal cancer; Risk factor; Dysplasia; Surveillance colonoscopy; Chemoprevention

Core tip: Colorectal cancer (CRC) is more frequent in patients with long-term ulcerative colitis (UC), and is one of the most serious and life threatening consequences of UC. Knowledge of risk factors for CRC is important to identify UC patients who need surveillance. Colonoscopy surveillance programs are recommended to reduce the risk of CRC and mortality in UC. Genetic alterations might play a role in the development of CRC in UC patients. 5-aminosalicylates might represent a favorable therapeutic option for chemoprevention of CRC.