Colorectal cancer in inflammatory bowel disease: The risk, pathogenesis, prevention and diagnosis

Table 1 Summary of cumulative risk of colorectal cancer in patients with inflammatory bowel disease in recent population-based studies and meta-analysis

Study	Country (n)	Population (n)	Observed period	Incidence of colorectal cancer
Eaden et al[5]	United States (4), United Kingdom (7), Scandinavia (3), other (5)	UC (meta-analysis of 19 studies)	1925-1999	Cumulative incidence
				1.6% by 10 yr of disease
				8.3% by 20 yr of disease
				18.4% by 30 yr of disease
Winther et al[6]	Copenhagen County, Denmark	1161 UC	1962-1987	Cumulative probability
				0.4% by 10 yr of disease
				1.1% by 20 yr of disease
				2.1% by 30 yr of disease
Lakatos et al[14]	Veszprem, Hungary	723 UC	1974-2004	Cumulative risk
				0.6% by 10 yr of disease
				5.4% by 20 yr of disease
				7.5% by 30 yr of disease
Rutter et al[84]	London, United Kingdom	600 long standing extensive UC	1971-2000	Cumulative incidence
				0% by 10 yr of disease
				2.5% by 20 yr of disease
				7.6% by 30 yr of disease
				10.8% by 40 yr of disease
Söderlund et al[8]	Sweden	7607 UC	1954-1989	Cumulative risk
				1.5% by 10 yr of disease
				3.8% by 20 yr of disease
				7.6% by 30 yr of disease
Canavan et al[9]	United States (3), Denmark (3), United Kingdom (2), Sweden (2), Canada (1), Israel (1)	11545 CD (meta-analysis of 12 studies)	1972-2004	Cumulative risk
				2.9% by 10 yr of disease
				5.6% by 20 yr of disease
				8.3% by 30 yr of disease
Kim et al[7]	South Korea	7061 UC	1970-2005	Cumulative risk
				0.7% by 10 yr of disease
				7.9% by 20 yr of disease
				33.2% by 30 yr of disease

CD: Crohn’s disease; UC: Ulcerative colitis.

Table 2 Summary of the screening and surveillance recommendation from international guidelines for patients with inflammatory bowel disease

	ECCO 2008	BSG 2010	AGA 2010	ACG 2010
1st screening	8-10 yr	10 yr	Max 8 yr	8-10 yr
	Extensive: 2 yearly to 20 yr then annually	By risk: low 5 yr	1-3 yr
Surveillance interval	Left sided: 2 yearly starting at 15 yr	Intermediate 3 yr	More often at high risk e.g., PSC	1-2 yr
	PSC: 1 yr	High 1 yr
Random biopsy	Recommended	Recommended	Recommended	Recommended
Chromoendoscopy	Superior to white light endoscopy	≥ 33 if no chromo	≥ 33	≥ 33

ECCO: European Crohn’s and Colitis Organization; BSG: British Society of Gastroenterology; AGA: American Gastroenterological Association; ACG: American College of Gastroenterology; PSC: Primary sclerosing cholangitis. Modified from Ref [80].