Narrative review of colorectal cancer risk in patients with inflammatory bowel disease

Abstract

: Inflammatory bowel disease (IBD) is a complex pathology that raises the risk of developing an oncological disease, mainly with the highest risk of developing dysplasia, colorectal cancer (CRC) in patients with Ulcerative Colitis (UC) and Small-Bowel Adenocarcinoma in patients with Crohn’s disease (CD). The risk of developing these complications has decreased in recent years worldwide thanks to new treatments that achieve mucosal healing with long periods of remission and surveillance programs. The risk factors are different from those in patients with CRC in the general population. The main known factors in IBD are the extent and duration of the disease and the presence of primary sclerosing cholangitis (PSC) among others. There is evidence that genetic factor changes in the mucosa usually occur in less time than in the general population, that is why endoscopic surveillance programs have been implemented and are recommended depending on the risk factors of each patient, it is important to detect early precancerous lesions to perform timely treatment, it can be endoscopic with resection of the mucosa in early stages and visible lesions by the endoscopist, but in some cases where endoscopic treatment can’t be performed or it is not recommended surgical treatment may be performed, to prevent the development of CRC, reduce mortality and improve survival rates.