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Interval colorectal cancers in inflammatory bowel disease: the grim statistics and true stories
Silvia Sanduleanu1, Matthew D Rutter2
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Postbox 5800, 6202 AZ, Maastricht, The Netherlands.
Abstract:
Interval colorectal cancers (CRCs) may account for approximately one half of all CRCs identified during IBD surveillance. The etiology of interval CRCs is multifactorial, with procedural factors likely to play a major role. Molecular events promoted by inflamed mucosa may augment the cancer risk and perhaps explain some interval CRCs. This article reviews key studies relating to CRC risk in the patient with IBD, paying particular attention to the occurrence of interval CRCs. The most common factors implicated in the etiology of interval CRCs, in particular missed, incompletely resected lesions, the adherence to recommended surveillance intervals and biologic pathways associated with a faster progression to cancer are examined. Basic concepts for quality and effectiveness of colonoscopic surveillance in IBD are summarized.
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