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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2016; 22(3): 961-973
Published online Jan 21, 2016. doi: 10.3748/wjg.v22.i3.961
Inflammatory bowel disease associated neoplasia: A surgeon’s perspective
Azah A Althumairi, Mark G Lazarev, Susan L Gearhart
Azah A Althumairi, Susan L Gearhart, Division of Colorectal Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
Mark G Lazarev, Division of Gastroenterology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
Author contributions: Althumairi AA performed the study design, literature review, and drafted the manuscript; Gearhart SL drafted the manuscript and performed critical revision and editing; Lazarev MG performed critical revision and editing; all authors approved the final version to be published.
Conflict-of-interest statement: No potential conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Susan L Gearhart, MD, Division of Colorectal Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Blalock 618, 600 North Wolfe Street, Baltimore, MD 21287, United States. sdemees1@jhmi.edu
Telephone: +1-410-9557323 Fax: +1-410-6149866
Received: August 11, 2015
Peer-review started: August 11, 2015
First decision: September 29, 2015
Revised: September 30, 2015
Accepted: November 19, 2015
Article in press: November 19, 2015
Published online: January 21, 2016
Abstract

Inflammatory bowel disease (IBD) is associated with increased risk of colorectal cancer (CRC). The risk is known to increase with longer duration of the disease, family history of CRC, and history of primary sclerosing cholangitis. The diagnosis of the neoplastic changes associated with IBD is difficult owing to the heterogeneous endoscopic appearance and inter-observer variability of the pathological diagnosis. Screening and surveillance guidelines have been established which aim for early detection of neoplasia. Several surgical options are available for the treatment of IBD-associated neoplasia. Patients’ morbidities, risk factors for CRC, degree and the extent of neoplasia must be considered in choosing the surgical treatment. A multidisciplinary team including the surgeon, gastroenterologist, pathologist, and the patient who has a clear understanding of the nature of their disease is needed to optimize outcomes.

Keywords: Inflammatory bowel disease, Dysplasia, Colorectal cancer, Endoscopy, Surveillance, Colectomy

Core tip: This review summarizes the natural history of inflammatory bowel disease associated dysplasia and colorectal cancer. An up to date review of risk factors for inflammatory bowel disease associated colorectal cancer is included. Highlights include surgeon specific factors to aid in joint decision making with the patient regarding further management of their disease. These factors include the management options of continued appropriate endoscopic surveillance and the different disease specific surgical options. Finally, it summarizes the long-term surveillance program and the long-term prognosis following surgery for inflammatory bowel disease associated neoplasia.