Inflammatory bowel disease and colorectal cancer

  • Andreja Ocepek
  • Pavel Skok
Keywords: inflammatory bowel disease, Crohn’s disease, ulcerative colitis, colorectal cancer, genetic markers


Background: Colorectal cancer is one of the most frequent cancers in developed countries and Slovenia, and the incidence is still rising. Groups of people with higher risk for colorectal cancer are well defined. Among them are patients with inflammatory bowel disease. The risk is highest in patients in whom whole large bowel is affected by inflammation, it rises after 8 to 10 years and increases with the duration of the disease. Precancerous lesion is a displastic, chronically inflammed mucosa and not an adenoma as in cases of sporadic colorectal carcinoma.

Conclusions: Many studies suggest that the influence of genetic factors differs between sporadic and inflammatory bowel disease related colorectal cancer. Symptomatic patients at the time of diagnosis have a much worse prognosis. The goal of prevention programes is therefore discovering early precancerous lesions. Established screening protocols are based on relatively frequent colonoscopies which are inconvinient for the patient as well as the endoscopist. Use of specific genetic markers, mutations of candidate genes, as a screening method and a prognostic predictor could greatly lighten therapeutic decisions.


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Ferkolj I. Epidemiologija kronične vnetne črevesne bolezni (KVČB). Gastroenterolog 1998; 2: 5–6.

Andres PG, Friedman LS. Epidemiology and the natural course of inflammatory bowel disease. Inflammatory Bowel Diseases 1999; 28: 255–81.

Jereb J. Epidemiologija, etiologija in patogeneza kronične vnetne črevesne bolezni (KVČB). Gastroenterolog 1998; 2: 7–9.

Marteau P. Inflammatory bowel disease. Endoscopy 2002; 34: 63–8.

Yang H, McElree C, Roth MP, Shanahan F, Targan SR, Rotter JI. Familial empirical risks for inflammatory bowel disease: Differences between Jews and non-Jews. Gut 1993; 34: 517.

Peeters M, Nevens H, Baert F, et al. Familial aggregation in Crohn’s disease: Increased age adjusted risk and concordance in clinical characteristics. Gastroenterology 1996; 111: 597.

Duerr RH. Update on the genetics of inflammatory bowel disease. J Clin Gastroenterol 2003; 37: 358–67.

Gillen CD, Walmsley RS, Prior P, Andrews HA, Allan RN. Ulcerative colitis and Crohn’s disease: A comparison of the colorectal cancer risk in extensive colitis. Gut 1994; 35: 1590.

Potočnik U, Cerar A, Jeruc J, Ferkolj I, Dean M, Glavač D. Molekularno diagnostični in napovedni označevalci pri kroničnih vnetjih črevesa. In: Luzar B, et al. ur. Molekularna diagnostika v medicini – Zbornik predavanj. Ljubljana: Littera Picta; 2005. p. 221–30.

Bonen DK, Cho JH. The genetics of inflammatory bowel disease. Gastroenterology 2003; 124: 521–36.

Incidenca raka v Sloveniji 2000. Ljubljana: Onkološki inštitut, Register raka za Slovenijo, 2003.

Incidenca raka v Sloveniji 2001. Ljubljana: Onkološki inštitut, Register raka za Slovenijo, 2004.

Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from twenty-five cancers in 1990. Int J Cancer 1999; 83: 18–29.

Coleman MP, Gatta G, Verdecchia A, Estève J, Sant M, Storm H, et al. Eurocare-3 summary: cancer survival in Europe at the end of the 20th century. Ann of Oncol 2003; 14 Suppl 5: 128–49.

Rhodes JM. Colorectal cancer screening in the UK: Joint position statement by the British Society of Gastroenterology, the Royal College of Physicians, and the Association of Coloproctology of Great Britain and Ireland. Gut 2000; 46: 746–8.

Markovič S, Repše S, Heijnen S. Obvladovanje kolorektalnega karcinoma. Nacionalna klinična smernica. Projekt razvoja sistema upravljanja zdravstvenega varstva. Ljubljana: Ministrstvo za zdravje; 2002.

Pompe-Kirn V, Golouh R, Lindtner J, Primic-Žakelj M, Ravnihar B, eds. Incidenca raka v Sloveniji 2000. Ljubljana: Onkološki inštitut, Register raka za Slovenijo, 2003.

Štabuc B, Zakotnik B, Markovič S, Repše S, Benulič T, Golouh R. Adjuvantno zdravljenje bolnikov z operabilnim rakom debelega črevesa. Ljubljana: Onkološki inštitut; 1992.

Freed N. Colorectal carcinoma: Epidemiology and risk factors. Journal of AOA 1984; 84: 269–75.

Farmer RG, Whelan G, Fazio VW. Long-term follow-up of patients with Crohn’s disease. Gastroenterology 1985; 88: 1818.

Polito JM, Childs B, Mellits ED, Tokayer AZ, Harris ML, Bayless TM. Crohn’s disease: influence of age at diagnosis on site and clinical type of disease. Gastroenterology 1996; 111: 580.

Pohl C, Hombach A, Kruis W. Chronic inflammatory bowel disease and cancer. Hepato-gastroenterology 2000; 47: 57–70.

Senay E, Sachar DB, Keohane M, Greenstein AJ. Small bowel carcinoma in Crohn’s disease. Distinguishing features and risk factors. Cancer 1989; 63: 360–3.

Itzkowitz S. Colon carcinogenesis in inflammatory bowel disease. Applying molecular genetics to clinical practice. J Clin Gastroenterol 2003; 36 Suppl 1: 70–4.

Peppercorn MA, Odze RD. Colorectal cancer surveillance in inflammatory bowel disease. UpToDate 2002; 10(1).

Murthy S, Flanigan A, Clearfield H. Colorectal cancer in inflammatory bowel disease: molecular and clinical features. Gastroenterol Clin N Am 2002; 31: 551–64.

Borchers R, Heinzlmann M, Zahn R, Witter K, Martin K, Loeschke K, et al. K-ras mutations in sera of patients with colorectal neoplasias and long-standing inflammatory bowel disease. Scand J Gastroenterol 2002; 37: 715–8.

Koželj M. Kronična vnetna črevesna bolezen in kolorektalni karcinom. Gastroenterolog 1998; 2: 39–40.

Skok P, Ocepek A. The risk of colorectal cancer in patients with inflammatory bowel disease. In: Knjiga sažetaka. Zagreb: Hrvatsko gastroenterološko društvo, 2006: 17.

How to Cite
Ocepek A, Skok P. Inflammatory bowel disease and colorectal cancer. ZdravVestn [Internet]. 1 [cited 14Nov.2019];75. Available from:
Review article