Onkologie. 2013:7(4):167-171

Inflammatory bowel diseases and colorectal cancer

prof.MUDr.Přemysl Frič, DrSc., prof.MUDr.Miroslav Zavoral, PhD.

Interní klinika, 1. lékařská fakulta Univerzity Karlovy, Ústřední vojenská nemocnice &ndash, Vojenská fakultní nemocnice Praha

Colorectal cancer (CRC) originates in approximately one per cent of subjects with idiopathic bowel disease (IBD). Nevertheless, it participates

on their mortality by 10–20 per cent. IBD-associated CRC appears at an earlier age than sporadic CRC. IBD-associated CRC is

accompanied by similar genetic markers as sporadic CRC, but their order and frequency are different. IBD-associated cancer is frequently

multifocal and more aggressive, The risk factors include: duration and extent of colitis, beginning of IBD at an early age and ongoing

disease at a higher age (above 60 years), endoscopic and histological severity of inflammation, family history of sporadic CRC, and co-

-existent primary sclerosing cholangitis. Prevention of IBD-associated CRC in long-standing disease requires a surveillance program. Its

main steps include: annual or biannual colonoscopies, four-quadrant biopsies obtained every 10 centimeters and finding of dysplasia

(unequivocal malignant transformation of the epithelium without involvement of mucosal lamina propria). The confirmation of intraepithelial

neoplasia requires surgery, Modern endoscopic techniques improve the detection of dysplastic lesions and enable to lower the

number of biopsies. Biomarkers of molecular genetics may improve future results of the surveillance program.

treatment and prevention of dysplasia.

Keywords: idiopathic bowel disease, associated colorectal cancer, risk factors, surveillance program, dysplasia, molecular biomarkers,

Published: October 1, 2013  Show citation