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CC BY-NC-ND 4.0 · South Asian J Cancer 2024; 13(04): 300-304
DOI: 10.1055/s-0045-1802335
Review Article
Etiology

Inflammatory Bowel Disease and Colorectal Cancer: An Eternal Fire in a Beautiful Garden

Authors

  • Venkata Pradeep Babu Koyyala 

    1   Department of Medical Oncology, Shankara Cancer and Research Institute, Tezpur, Assam, India

  • Chetan Kantharia

    2   Department of Surgical Gastroenterology, Nanavati Super Specialty Hospital, Mumbai, Maharashtra, India
    3   Department of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India

  • Naitica Darooka

    4   Department of Medicine, KEM Hospital, Mumbai, Maharashtra, India

  • Mandhir Kumar

    3   Department of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India

  • Piyush Ranjan

    3   Department of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India

  • Shrihari Anikhindi

    3   Department of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India

  • Naresh Kumar Bansal

    3   Department of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India

  • Praveen Sharma

    3   Department of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India

  • Dr. V.P. Bhalla

    16   Department of Surgical Gastroenterology, PSRI Hospital, New Delhi, India

  • Manish Kumar

    5   Department of Medical Oncology, Cloud Physician, Bengaluru, Karnataka, India

  • Mohit Sharma

    6   Department of Medical Oncology, Fortis Hospital, Faridabad, Haryana, India

  • Deepak Abrol

    7   Department of Radiation Oncology, American Oncology Institute, Jammu, India

  • Peush Sahni

    8   Department of Surgical Gasteroenterology, AIIMS, New Delhi, India

  • Ramesh Ardhanari

    9   Department of Surgical Gastroenterology, Meenakshi Mission Hospital, Madurai, Tamil Nadu, India

  • R. Pradeep

    10   Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India

  • Amitabh Yadav

    11   Department of Surgical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India

  • Suviraj John

    12   Minimal Access Surgery Department, Sir Ganga Ram Hospital, New Delhi, India

  • Saumitra Rawat

    11   Department of Surgical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India

  • Purvish Parikh

    13   Department of Clinical Hematology, Sri Ram Cancer Center, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India

  • C. Selvasekar

    14   Divisional Medical Director, Clinical Services & Specialist Surgery, The Christie NHS Foundation Trust, Manchester, United Kingdom

  • Shyam Aggarwal

    15   Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India

Funding None.
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Abstract

Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, significantly increases the risk of colitis-associated cancer (CAC). Chronic inflammation, a key contributor to carcinogenesis, disrupts immune surveillance, induces deoxyribonucleic acid (DNA) damage, and alters genetic and epigenetic pathways. Molecular pathways such as STAT3, mTOR, and NF-κB drive CAC progression, while unique microbiome alterations—loss of Faecalibacterium prausnitzii and increases in Escherichia coli and Fusobacterium species—exacerbate the inflammatory milieu. CAC accounts for 2% of all colon cancers and up to 15% of IBD-related deaths. Risk correlates with IBD duration, increasing approximately 1% annually after the first decade. Surveillance via colonoscopy is crucial, with chromoendoscopy recommended for high-risk cases. Preventive drugs, including aminosalicylates, thiopurines, and biologics, offer modest benefits but lack conclusive evidence. Post-CAC diagnosis, immunosuppressants are discontinued in favor of corticosteroids, with 5-aminosalicylates continued as needed. The use of immune checkpoint inhibitors remains controversial due to exacerbation of colitis. Emerging insights into the gut microbiota's role in IBD and CAC may revolutionize prevention and management strategies. Advances in screening, surveillance, and therapeutic approaches have reduced CAC mortality, underscoring the importance of personalized medicine and ongoing research to address these complex conditions.

Keywords

hereditary risk - immune deficiency - cytokine - precancerous


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Artikel online veröffentlicht:
28. Januar 2025

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