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Screening for Colon Cancer in Inflammatory Bowel Disease

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Cancer Screening in Inflammatory Bowel Disease

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Abstract

The development of colorectal cancer (CRC) is one of the most dreaded complications of long-standing inflammatory bowel disease (IBD). The field of CRC surveillance in the IBD patient has come a long way since Crohn and Rosenberg’s initial description in 1925 of malignancy in an IBD patient. This chapter reviews the latest data and concepts regarding the effectiveness of colonoscopy as a screening tool for colorectal cancer in IBD, recommended screening, and surveillance intervals and techniques (including chromoendoscopy), as well as how to describe and manage precancerous lesions once found.

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References

  1. Lopez A, Collet-Fenetrier B, Belle A, Peyrin-Biroulet L. Patients’ knowledge and fear of colorectal cancer risk in inflammatory bowel disease. J Dig Dis. 2016;17(6):383–91.

    Article  PubMed  Google Scholar 

  2. Crohn BB, Rosenberg H. The sigmoidoscopic pictureof chronic ulcerative colitis (non-specific). Am J Med Sci. 1925;170:220–8.

    Article  Google Scholar 

  3. Warren S, Sommers SC. Cicatrizing enteritis (regional ileitis) as a pathologic entity. Am J Pathol. 1948;24:475–501.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Jones JH. Colonic cancer and Crohn’s disease. Gut. 1969;10:651–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Lutgens MW, Oldenburg B, Siersema PD, van Bodegraven AA, Dijkstra G, Hommes DW, et al. Colonoscopic surveillance improves survival after colorectal cancer diagnosis in inflammatory bowel disease. Br J Cancer. 2009;101(10):1671–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Choi PM, Nugent FW, Schoetz DJ Jr, et al. Colonoscopic surveillance reduces mortality from colorectal cancer in ulcerative colitis. Gastroenterology. 1993;105:418–24.

    Article  CAS  PubMed  Google Scholar 

  7. Eaden J, Abrams K, Ekbom A, et al. Colorectal cancer prevention in ulcerative colitis: a case-control study. Aliment Pharmacol Ther. 2000;14:145–53.

    Article  CAS  PubMed  Google Scholar 

  8. Karlen P, Kornfeld D, Brostrom O, et al. Is colonoscopic surveillance reducing colorectal cancer mortality in ulcerative colitis? A population based case control study. Gut. 1998;42:711–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Lashner BA, Kane SV, Hanauer SB. Colon cancer surveillance in chronic ulcerative colitis: a historical cohort study. Am J Gastroenterol. 1990;85:1083–7.

    CAS  PubMed  Google Scholar 

  10. American Society for Gastrointestinal Endoscopy Standards of Practice Committee, Shergill AK, Lightdale JR, Bruining DH, Acosta RD, Chandrasekhara V, et al. The role of endoscopy in inflammatory bowel disease. Gastrointest Endosc. 2015;81(5):1101–21.e1–13.

    Article  Google Scholar 

  11. Farraye FA, Odze RD, Eaden J, Itzkowitz SH, McCabe RP, Dassopoulos T, et al. AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology. 2010;138(2):738–45.

    Article  PubMed  Google Scholar 

  12. Cairns SR, Scholefield JH, Steele RJ, Dunlop MG, Thomas HJ, Evans GD, et al. Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002). Gut. 2010;59(5):666–89.

    Article  PubMed  Google Scholar 

  13. Annese V, Daperno M, Rutter MD, et al. European evidence based consensus for endoscopy in inflammatory bowel disease. J Crohn’s Colitis. 2013;7:982–1018.

    Article  Google Scholar 

  14. Kornbluth A, Sachar DB, Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults: American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010;105(3):501–23; quiz 24.

    Article  PubMed  Google Scholar 

  15. SCENIC international consensus statement on surveillance and management of dysplasia in inflammatory bowel disease. Gastrointest Endosc. 2015;81(3):489–501.

    Google Scholar 

  16. Mowat C, Cole A, Windsor A, et al. Guidelines on the management of inflammatory bowel disease in adults. Gut. 2011;60:571–607.

    Article  PubMed  Google Scholar 

  17. Howdle P, Wendy A, Rutter M. Colonoscopic surveillance for prevention of colorectal cancer in people with ulcerative colitis, Crohn’s disease or adenomas. National Institute for Health and Clinical Excellence (NICE) Clinical guideline. National Institutes of Health and Clinical Excellence;118. London: National Institute for Health and Clinical Excellence; 2011.

    Google Scholar 

  18. Party CCACSW, editor. Clinical Practice Guidelines for Surveillance Colonoscopy in adenoma follow-up; following curative resection of colorectal cancer; and for cancer surveillance in inflammatory bowel disease. Sydney: Cancer Council of Australia; 2011.

    Google Scholar 

  19. Van Assche G, Dignass A, Bokemeyer B, Danese S, Gionchetti P, Moser G, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 3: special situations. J Crohns Colitis. 2013;7(1):1–33.

    Article  PubMed  Google Scholar 

  20. Kaminski MF, Hassan C, Bisschops R, et al. Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2014;46(05):435–57.

    Article  PubMed  Google Scholar 

  21. Iannone A, Ruospo M, Wong G, Principi M, Barone M, Strippoli GFM, et al. Chromoendoscopy for surveillance in ulcerative colitis and Crohn’s disease: a systematic review of randomized trials. Clin Gastroenterol Hepatol. 2017;15(11):1684–97.e11.

    Article  PubMed  Google Scholar 

  22. Soetikno R, Subramanian V, Kaltenbach T, Rouse RV, Sanduleanu S, Suzuki N, et al. The detection of nonpolypoid (flat and depressed) colorectal neoplasms in patients with inflammatory bowel disease. Gastroenterology. 2013;144(7):1349–52, 52.e1–6.

    Article  PubMed  Google Scholar 

  23. Carballal S, Maisterra S, Lopez-Serrano A, Gimeno-Garcia AZ, Vera MI, Marin-Garbriel JC, et al. Real-life chromoendoscopy for neoplasia detection and characterisation in long-standing IBD. Gut. 2018;67(1):70–8.

    Article  PubMed  Google Scholar 

  24. Mooiweer E, van der Meulen-de Jong AE, Ponsioen CY, Fidder HH, Siersema PD, Dekker E, et al. Chromoendoscopy for surveillance in inflammatory bowel disease does not increase neoplasia detection compared with conventional colonoscopy with random biopsies: results from a large retrospective study. Am J Gastroenterol. 2015;110(7):1014–21.

    Article  CAS  PubMed  Google Scholar 

  25. Iacucci M, Kaplan GG, Panaccione R, Akinola O, Lethebe BC, Lowerison M, et al. A randomized trial comparing high definition colonoscopy alone with high definition dye spraying and electronic virtual chromoendoscopy for detection of colonic neoplastic lesions during IBD surveillance colonoscopy. Am J Gastroenterol. 2018;113(2):225–34.

    Article  PubMed  Google Scholar 

  26. Nett A, Velayos F, McQuaid K. Quality bowel preparation for surveillance colonoscopy in patients with inflammatory bowel disease is a must. Gastrointest Endosc Clin N Am. 2014;24(3):379–92.

    Article  PubMed  Google Scholar 

  27. Harewood GC, Sharma VK, de Garmo P. Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia. Gastrointest Endosc. 2003;58(1):76–9.

    Article  PubMed  Google Scholar 

  28. Rex DK, Imperiale TF, Latinovich DR, Bratcher LL. Impact of bowel preparation on efficiency and cost of colonoscopy. Am J Gastroenterol. 2002;97(7):1696–700.

    Article  PubMed  Google Scholar 

  29. Froehlich F, Wietlisbach V, Gonvers J-J, et al. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy_the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc. 2005;61(3):378–84.

    Article  PubMed  Google Scholar 

  30. Parra-Blanco A, Nicolas-Perez D, Gimeno-Garcia A, et al. The timing of bowel preparation before colonoscopy determines the quality of cleansing, and is a significant factor contributing to the detection of flat lesions: a randomized study. World J Gastroenterol. 2006;12(38):6161–6.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Bessissow T, Van Keerberghen C-A, Van Oudenhove L, et al. Anxiety is associated with impaired tolerance of colonoscopy preparation in inflammatory bowel disease and controls. J Crohn’s Colitis. 2013;7(11):e580–e7.

    Article  Google Scholar 

  32. Lim SW, Seo YW, Sinn DH, et al. Impact of previous gastric or colonic resection on polyethylene glycol bowel preparation for colonoscopy. Surg Endosc. 2012;26:1554–9.

    Article  PubMed  Google Scholar 

  33. Chung YW, Han DS, Park KH, et al. Patient factors predictive of inadequate bowel preparation using polyethylene glycol. J Clin Gastroenterol. 2009;43:448–52.

    Article  PubMed  Google Scholar 

  34. Kilgore TW, Abdinoor AA, Szary NM, et al. Bowel preparation with split-dose polyethylene glycol before colonoscopy: a meta-analysis of randomized controlled trials. Gastrointest Endosc. 2011;73(6):1240–5.

    Article  PubMed  Google Scholar 

  35. Enestvedt BK, Tofani C, Laine LA, Tierney A, Fennerty MB. 4-Liter split-dose polyethylene glycol is superior to other bowel preparations, based on systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2012;10(11):1225–31.

    Article  CAS  PubMed  Google Scholar 

  36. Gurudu SR, Ramirez FC, Harrison ME, et al. Increased adenoma detection rate with system-wide implementation of a split-dose preparation for colonoscopy. Gastrointest Endosc. 2012;76:603–8.

    Article  PubMed  Google Scholar 

  37. Johnson DA, Barkun AN, Cohen LB, Dominitz JA, Kaltenbach T, Martel M, et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2014;109(10):1528–45.

    Article  PubMed  Google Scholar 

  38. Toruner M, Harewood GC, Loftus EV Jr, et al. Endoscopic factors in the diagnosis of colorectal dysplasia in chronic inflammatory bowel disease. Inflamm Bowel Dis. 2005;11(5):428–34.

    Article  PubMed  Google Scholar 

  39. Sanduleanu S, Kaltenbach T, Barkun A, McCabe RP, Velayos F, Picco MF, et al. A roadmap to the implementation of chromoendoscopy in inflammatory bowel disease colonoscopy surveillance practice. Gastrointest Endosc. 2016;83(1):213–22.

    Article  PubMed  Google Scholar 

  40. Picco MF, Pasha S, Leighton JA, Bruining D, Loftus EV, Thomas CS, et al. Procedure time and the determination of polypoid abnormalities with experience. Inflamm Bowel Dis. 2013;19:1913–20.

    PubMed  Google Scholar 

  41. Kiesslich R, Fritsch J, Holtmann M, Koehler HH, Stolte M, Kanzler S, et al. Methylene blue-aided chromoendoscopy for the detection of intraepithelial neoplasia and colon cancer in ulcerative colitis. Gastroenterology. 2003;124(4):880–8.

    Article  PubMed  Google Scholar 

  42. Leong RW, Butcher RO, Picco MF. Implementation of image-enhanced endoscopy into solo and group practices for dysplasia detection in Crohn’s disease and ulcerative colitis. Gastrointest Endosc Clin N Am. 2014;24(3):419–25.

    Article  PubMed  Google Scholar 

  43. Konijeti GG, Shrime MG, Ananthakrishnan AN, Chan AT. Cost effectiveness analysis of chromoendsocopy for colorectal cacner surveillance in patients with ulcerative colitis. Gastrointest Endosc. 2014;79:455–65.

    Article  PubMed  Google Scholar 

  44. Margulis AR, Goldberg HI, Lawson TL, et al. The overlapping spectrum of ulcerative and granulomatous colitis: a roentgenographic-pathologic study. Am J Roentgenol Radium Therapy, Nucl Med. 1971;113:325–34.

    Article  CAS  Google Scholar 

  45. Maggs JR, Browning LC, Warren BF, Travis SP. Obstructing giant post-inflammatory polyposis in ulcerative colitis: case report and review of the literature. J Crohns Colitis. 2008;2(2):170–80.

    Article  PubMed  Google Scholar 

  46. De Dombal FT, Watts JM, Watkinson G, Goligher JC. Local complications of ulcerative colitis: stricture, pseudopolyposis, and carcinoma of the colon and rectum. Br Med J. 1966;1:1442–7.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Velayos FS, Loftus EV Jr, Jess T, Harmsen WS, Bida J, Zinsmeister AR, et al. Predictive and protective factors associated with colorectal cancer in ulcerative colitis: a case-control study. Gastroenterology. 2006;130(7):1941–9.

    Article  PubMed  Google Scholar 

  48. Rutter MD, Saunders BP, Wilkinson KH, Rumbles S, Schofield G, Kamm MA, et al. Cancer surveillance in longstanding ulcerative colitis: endoscopic appearances help predict cancer risk. Gut. 2004;53(12):1813–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Baars JE, Looman CWN, Steyerberg EW, Beukers R, Tan ACITL, Weusten BLAM, et al. The risk of inflammatory bowel disease-related colorectal carcinoma is limited: results from a nationwide nested case–control study. Am J Gastroenterol. 2010;106(2):319–28.

    Article  PubMed  Google Scholar 

  50. Dukes CE. The surgical pathology of ulcerative colitis. Ann R Coll Surg Engl. 1954;14:389–400.

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Kusunoki M, Nishigami T, Yanagi H, et al. Occult cancer localized in giant pseudopolyposis. Am J Gastroenterol. 1992;87(3):379–81.

    CAS  PubMed  Google Scholar 

  52. Farraye FA, Waye JD, Moscandrew M, Heeren TC, Odze RD. Variability in the diagnosis and management of adenoma-like and non-adenoma-like dysplasia-associated lesions or masses in inflammatory bowel disease: an Internet-based study. Gastrointest Endosc. 2007;66(3):519–29.

    Article  PubMed  Google Scholar 

  53. Kudo S-E, Tamura S, Nakajima T, et al. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc. 1996;44(1):8–14.

    Article  CAS  PubMed  Google Scholar 

  54. Koinuma K, Togashi K, Konishi F, Kirii Y, Horie H, Okada M, et al. Localized giant inflammatory polyposis of the cecum associated with distal ulcerative colitis. J Gastroenterol. 2003;38(9):880–3.

    Article  PubMed  Google Scholar 

  55. Bernstein CN. The color of dysplasia in ulcerative colitis. Gastroenterology. 2003;124:1135–49.

    Article  PubMed  Google Scholar 

  56. Choi YS, Suh JP, Lee IT, Kim JK, Lee SH, Cho KR, et al. Regression of giant pseudopolyps in inflammatory bowel disease. J Crohns Colitis. 2012;6(2):240–3.

    Article  CAS  PubMed  Google Scholar 

  57. Itzkowitz SH, Present DH. Consensus conference: colorectal cancer screening and surveillance in inflammatory bowel disease. Inflamm Bowel Dis. 2005;11:314–21.

    Article  PubMed  Google Scholar 

  58. Itzkowitz SH, Harpaz N. Diagnosis and management of dysplasia in patients with inflammatory bowel diseases. Gastroenterology. 2004;126(6):1634–48.

    Article  PubMed  Google Scholar 

  59. Gumaste V, Sachar DB, Greenstein AJ. Benign and malignant colorectal strictures in ulcerative colitis. Gut. 1992;33:938–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Reiser JR, Waye JD, Janowitz HD, Harpaz N. Adenocarcinoma in strictures of ulcerative colitis without antecedent dysplasia by colonoscopy. Am J Gastroenterol. 1994;89(1):119–22.

    CAS  PubMed  Google Scholar 

  61. Rex DK, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, et al. Colorectal cancer screening: recommendations for physicians and patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2017;112(7):1016–30.

    Article  PubMed  Google Scholar 

  62. Day LW, Kwon A, Inadomi JM, Walter LC, Somsouk M. Adverse events in older patients undergoing colonoscopy: a systematic review and meta-analysis. Gastrointest Endosc. 2011;74(4):885–96.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Long MD, Sands BE. When do you start and when do you stop screening for colon cancer in inflammatory bowel disease? Clin Gastroenterol Hepatol. 2018;16(5):621–3.

    Article  PubMed  Google Scholar 

  64. The Paris classification of superficial neoplastic lesions: esophagus, stomach, and colon. Gastrointest Endosc. 2003;58(suppl):53–43.

    Google Scholar 

  65. Velayos F, Kathpalia P, Finlayson E. Changing paradigms in detection of dysplasia and management of patients with inflammatory bowel disease: is colectomy still necessary? Gastroenterology. 2017;152(2):440–50 e1.

    Article  PubMed  Google Scholar 

  66. Kaltenbach T, Sandborn WJ. Endoscopy in inflammatory bowel disease: advances in dysplasia detection and management. Gastrointest Endosc. 2017;86(6):962–71.

    Article  PubMed  Google Scholar 

  67. Wanders LK, Dekker E, Pullens B, Bassett P, Travis SP, East JE. Cancer risk after resection of polypoid dysplasia in patients with longstanding ulcerative colitis: a meta-analysis. Clin Gastroenterol Hepatol. 2014;12(5):756–64.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology and Center for Crohn’s and Colitis, University of California, San Francisco, San Francisco, CA, USA

    Kendall Beck

  2. Division of Gastroenterology and Hepatology, San Francisco Kaiser Permanente, San Francisco, CA, USA

    Fernando Velayos

  3. Regional Program for Inflammatory Bowel Disease, Kaiser Permanente Northern California, Oakland, CA, USA

    Fernando Velayos

Authors
  1. Kendall Beck
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  2. Fernando Velayos
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Correspondence to Kendall Beck .

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Editors and Affiliations

  1. Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Joseph D. Feuerstein

  2. Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Adam S. Cheifetz

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Beck, K., Velayos, F. (2019). Screening for Colon Cancer in Inflammatory Bowel Disease. In: Feuerstein, J., Cheifetz, A. (eds) Cancer Screening in Inflammatory Bowel Disease . Springer, Cham. https://doi.org/10.1007/978-3-030-15301-4_2

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  • DOI: https://doi.org/10.1007/978-3-030-15301-4_2

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