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Malignancy in Crohn's disease

D Bernstein¹, A Rogers

¹Division of Hepatology, University of Miami School of Medicine, Florida.

The American Journal of Gastroenterology

|March 1, 1996

Summary

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The risk of malignancy, particularly small bowel adenocarcinoma and colorectal carcinoma, is elevated in Crohn's disease patients. Key risk factors include disease duration, sex, and specific disease complications.

Area of Science:

Gastroenterology
Oncology

Background:

Malignancy risk in Crohn's disease (CD) is less defined than in ulcerative colitis.
The association between CD and gastrointestinal (GI) cancers requires further clarification.

Purpose of the Study:

To review the current literature on the association between Crohn's disease and various malignancies.
To define the magnitude of cancer risk in CD patients.

Main Methods:

Review of population-based, case-control, referral center studies, and case reports.
Focus on literature concerning small bowel adenocarcinoma and colorectal carcinoma in CD.

Main Results:

Increased risk of small bowel adenocarcinoma in CD patients compared to the general population, though magnitude is unclear.

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Risk factors for small bowel carcinoma in CD include male sex, disease duration, fistulas, and excluded bowel loops.

Crohn's colitis is linked to increased colorectal carcinoma risk, especially with long-standing disease, strictures, fistulas, and right-sided colonic disease.

Conclusions:

While secondary GI cancers are rare in CD, specific malignancies like small bowel adenocarcinoma and colorectal carcinoma present an elevated risk.
Identifying risk factors is crucial for monitoring and managing cancer risk in Crohn's disease patients.