The most common complications of Crohn’s disease are represented by stenosis, fistulas and abscesses that generally need a surgical therapy, despite drug treatment, newly with biological drugs have proved effective. Neoplastic degeneration is a terrible and feared complication in the long term. Although there is a substantial evidence that patients with ulcerative colitis are at increased risk of developing colorectal cancer, the prevalence of cancer in patients with Crohn’s disease is also not so well defined even if it’s now accepted that the risk of colorectal cancer is equivalent in both conditions. From a review of the literature it can be assumed that the number of cancer cases of large and small intestine associated with inflammatory bowel disease has increased both in patients with ulcerative colitis as well as in patients with Crohn's disease. The rectum, interested only in a small percentage of cases by Crohn's disease, does not seem to be subject to this consideration. Beside it the risk of developing extraintestinal tumors and lymphomas in patients with Crohn’s disease appears to have increased in relation to the general population, but, at present, evidences to establish secure real causal link between these disorders are still lacking. The role of immunosuppressive therapies, often carried out on patients with Crohn’s disease, also remains unclear. Cancer is often preceded by dysplasia in both patients with ulcerative colitis and in patients with Crohn's disease affection. Young patients who have severe Crohn's disease of long standing, with extensive colonic involvement may benefit from endoscopic surveillance for cancer, especially those affecting the large intestine. We’re waiting for good screening methods more sensitive, less invasive and less costly in terms of economic cost and discomfort for the patient. An attitude of alertness may be stated as good: the onset of new symptoms in a patient with up till now stable disease should always be investigated.

Colo-rectal cancer in patients affected on Crohn’s disease.

FORNARO, ROSARIO
2013-01-01

Abstract

The most common complications of Crohn’s disease are represented by stenosis, fistulas and abscesses that generally need a surgical therapy, despite drug treatment, newly with biological drugs have proved effective. Neoplastic degeneration is a terrible and feared complication in the long term. Although there is a substantial evidence that patients with ulcerative colitis are at increased risk of developing colorectal cancer, the prevalence of cancer in patients with Crohn’s disease is also not so well defined even if it’s now accepted that the risk of colorectal cancer is equivalent in both conditions. From a review of the literature it can be assumed that the number of cancer cases of large and small intestine associated with inflammatory bowel disease has increased both in patients with ulcerative colitis as well as in patients with Crohn's disease. The rectum, interested only in a small percentage of cases by Crohn's disease, does not seem to be subject to this consideration. Beside it the risk of developing extraintestinal tumors and lymphomas in patients with Crohn’s disease appears to have increased in relation to the general population, but, at present, evidences to establish secure real causal link between these disorders are still lacking. The role of immunosuppressive therapies, often carried out on patients with Crohn’s disease, also remains unclear. Cancer is often preceded by dysplasia in both patients with ulcerative colitis and in patients with Crohn's disease affection. Young patients who have severe Crohn's disease of long standing, with extensive colonic involvement may benefit from endoscopic surveillance for cancer, especially those affecting the large intestine. We’re waiting for good screening methods more sensitive, less invasive and less costly in terms of economic cost and discomfort for the patient. An attitude of alertness may be stated as good: the onset of new symptoms in a patient with up till now stable disease should always be investigated.
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11567/608358
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact