Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 7, 2008; 14(25): 3937-3947
Published online Jul 7, 2008. doi: 10.3748/wjg.14.3937
Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies
Peter Laszlo Lakatos, Laszlo Lakatos
Peter Laszlo Lakatos, 1st Department of Medicine, Semmelweis University, Budapest H-1083, Hungary
Laszlo Lakatos, 1st Department of Medicine, Csolnoky F. County Hospital, H-8201 Veszprem, Hungary
Author contributions: Lakatos PL and Lakatos L contributed equally to the searching and reviewing available literature and preparation of the manuscript.
Correspondence to: Peter Laszlo Lakatos, MD, PhD, 1st Department of Medicine, Semmelweis University, Koranyi Str. 2/A, Budapest H-1083, Hungary. kislakpet@bel1.sote.hu
Telephone: +36-1-2100278
Fax: +36-1-3130250
Received: March 19, 2008
Revised: April 18, 2008
Accepted: April 25, 2008
Published online: July 7, 2008

The risk of colorectal cancer for any patient with ulcerative colitis is known to be elevated, and is estimated to be 2% after 10 years, 8% after 20 years and 18% after 30 years of disease. Risk factors for cancer include extent and duration of ulcerative colitis, primary sclerosing cholangitis, a family history of sporadic colorectal cancer, severity of histologic bowel inflammation, and in some studies, young age at onset of colitis. In this review, the authors discuss recent epidemiological trends and causes for the observed changes. Population-based studies published within the past 5 years suggest that this risk has decreased over time, despite the low frequency of colectomies. The crude annual incidence rate of colorectal cancer in ulcerative colitis ranges from approximately 0.06% to 0.16% with a relative risk of 1.0-2.75. The exact mechanism for this change is unknown; it may partly be explained by the more widespread use of maintenance therapy and surveillance colonoscopy.

Keywords: Ulcerative colitis, Colorectal cancer, Risk factors, Surveillance, Chemoprevention