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World J Gastroenterol. Aug 21, 2012; 18(31): 4091-4094
Published online Aug 21, 2012. doi: 10.3748/wjg.v18.i31.4091
Colorectal cancer in patients with inflammatory bowel disease: Can we predict risk?
Vibeke Andersen, Jonas Halfvarson, Ulla Vogel
Vibeke Andersen, Medical Department, Sygehus Sønderjylland Aabenraa, DK-6200 Aabenraa, Denmark
Vibeke Andersen, Institute of Regional Health Services Research, University of Southern Denmark, DK-5000 Odense, Denmark
Jonas Halfvarson, Department of Internal Medicine, Örebro University Hospital, Örebro University, Örebro 70185, Sweden
Ulla Vogel, National Research Centre for the Working Environment, DK-2100 Copenhagen, Denmark
Author contributions: Andersen V collected the material and wrote the manuscript; Halfvarsson J discussed the topic; and Vogel U supervised the manuscript.
Correspondence to: Vibeke Andersen, Consultant, Specialist, Medical Department, Sygehus Sønderjylland Aabenraa, Kresten Philipsens Vej 15, DK-6200 Aabenraa, Denmark.
Telephone: +45-2-1157790 Fax: +45-8-8834488
Received: June 27, 2012
Revised: July 10, 2012
Accepted: July 18, 2012
Published online: August 21, 2012

The inflammatory bowel diseases (IBD), Crohn’s disease (CD) and ulcerative colitis (UC), may be complicated by colorectal cancer (CRC). In a recent population-based cohort study of 47 347 Danish patients with IBD by Tine Jess and colleagues 268 patients with UC and 70 patients with CD developed CRC during 30 years of observation. The overall risk of CRC among patients with UC and CD was comparable with that of the general population. However, patients diagnosed with UC during childhood or as adolescents, patients with long duration of disease and those with concomitant primary sclerosing cholangitis were at increased risk. In this commentary, we discuss the mechanisms underlying carcinogenesis in IBD and current investigations of genetic susceptibility in IBD patients. Further advances will depend on the cooperative work by epidemiologist and molecular geneticists in order to identify genetic polymorphisms involved in IBD-associated CRC. The ultimate goal is to incorporate genotypes and clinical parameters into a predictive model that will refine the prediction of risk for CRC in colonic IBD. The challenge will be to translate these new findings into clinical practice and to determine appropriate preventive strategies in order to avoid CRC in IBD patients. The achieved knowledge may also be relevant for other inflammation-associated cancers.

Keywords: Inflammatory bowel disease, Crohn’s disease, Ulcerative colitis, Colorectal cancer, Inflammation-associated cancer, Genetics, Preventive strategies