Prevention of cancer in IBD - A balancing act

J. Mill, Ian Lawrance

    Research output: Contribution to journalReview article

    7 Citations (Scopus)

    Abstract

    Inflammation and immunosuppression are two major risk factors for the development of carcinogenesis in inflammatory bowel disease (IBD). While the natural history of uncontrolled inflammation in the bowel may lead to a higher incidence of colorectal cancer (CRC), surveillance colonoscopy has resulted in earlier detection of dysplasia and cancer, prompting earlier surgical intervention and improved prognosis, while chemoprevention in the form of the anti-inflammatory 5-aminosalicylate acids and immunosuppression could potentially decrease the incidence of CRC. Numerous extra-intestinal cancers such as hepatobiliary and pancreatic malignancies, however, are also noted to be more prevalent in IBD patients particularly with co-existing primary sclerosing cholangitis. Somewhat ironically, however, the medications used to control the inflammation in IBD may also be responsible for the development of other cancers. The increased risk of lymphoma and skin cancers associated with immunosuppressive medication use may potentially be due to loss of immunosurveillance and in the case of lymphoma, the presence of oncogenic viruses (i.e., Epstein-Barr virus). Thus the challenge for both the treating physician and IBD patient is to balance the risk of any potential treatment against patient symptoms and the natural history of uncontrolled inflammation from their disease.
    Original languageEnglish
    Pages (from-to)261-272
    JournalMinerva Gastroenterologica e Dietologica
    Volume59
    Issue number3
    Publication statusPublished - 2013

    Fingerprint

    Inflammatory Bowel Diseases
    Inflammation
    Immunosuppression
    Colorectal Neoplasms
    Lymphoma
    Neoplasms
    Intestinal Neoplasms
    Immunologic Monitoring
    Mesalamine
    Oncogenic Viruses
    Sclerosing Cholangitis
    Incidence
    Chemoprevention
    Skin Neoplasms
    Colonoscopy
    Immunosuppressive Agents
    Human Herpesvirus 4
    Early Detection of Cancer
    Carcinogenesis
    Anti-Inflammatory Agents

    Cite this

    Mill, J. ; Lawrance, Ian. / Prevention of cancer in IBD - A balancing act. In: Minerva Gastroenterologica e Dietologica. 2013 ; Vol. 59, No. 3. pp. 261-272.
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    abstract = "Inflammation and immunosuppression are two major risk factors for the development of carcinogenesis in inflammatory bowel disease (IBD). While the natural history of uncontrolled inflammation in the bowel may lead to a higher incidence of colorectal cancer (CRC), surveillance colonoscopy has resulted in earlier detection of dysplasia and cancer, prompting earlier surgical intervention and improved prognosis, while chemoprevention in the form of the anti-inflammatory 5-aminosalicylate acids and immunosuppression could potentially decrease the incidence of CRC. Numerous extra-intestinal cancers such as hepatobiliary and pancreatic malignancies, however, are also noted to be more prevalent in IBD patients particularly with co-existing primary sclerosing cholangitis. Somewhat ironically, however, the medications used to control the inflammation in IBD may also be responsible for the development of other cancers. The increased risk of lymphoma and skin cancers associated with immunosuppressive medication use may potentially be due to loss of immunosurveillance and in the case of lymphoma, the presence of oncogenic viruses (i.e., Epstein-Barr virus). Thus the challenge for both the treating physician and IBD patient is to balance the risk of any potential treatment against patient symptoms and the natural history of uncontrolled inflammation from their disease.",
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    Mill, J & Lawrance, I 2013, 'Prevention of cancer in IBD - A balancing act' Minerva Gastroenterologica e Dietologica, vol. 59, no. 3, pp. 261-272.

    Prevention of cancer in IBD - A balancing act. / Mill, J.; Lawrance, Ian.

    In: Minerva Gastroenterologica e Dietologica, Vol. 59, No. 3, 2013, p. 261-272.

    Research output: Contribution to journalReview article

    TY - JOUR

    T1 - Prevention of cancer in IBD - A balancing act

    AU - Mill, J.

    AU - Lawrance, Ian

    PY - 2013

    Y1 - 2013

    N2 - Inflammation and immunosuppression are two major risk factors for the development of carcinogenesis in inflammatory bowel disease (IBD). While the natural history of uncontrolled inflammation in the bowel may lead to a higher incidence of colorectal cancer (CRC), surveillance colonoscopy has resulted in earlier detection of dysplasia and cancer, prompting earlier surgical intervention and improved prognosis, while chemoprevention in the form of the anti-inflammatory 5-aminosalicylate acids and immunosuppression could potentially decrease the incidence of CRC. Numerous extra-intestinal cancers such as hepatobiliary and pancreatic malignancies, however, are also noted to be more prevalent in IBD patients particularly with co-existing primary sclerosing cholangitis. Somewhat ironically, however, the medications used to control the inflammation in IBD may also be responsible for the development of other cancers. The increased risk of lymphoma and skin cancers associated with immunosuppressive medication use may potentially be due to loss of immunosurveillance and in the case of lymphoma, the presence of oncogenic viruses (i.e., Epstein-Barr virus). Thus the challenge for both the treating physician and IBD patient is to balance the risk of any potential treatment against patient symptoms and the natural history of uncontrolled inflammation from their disease.

    AB - Inflammation and immunosuppression are two major risk factors for the development of carcinogenesis in inflammatory bowel disease (IBD). While the natural history of uncontrolled inflammation in the bowel may lead to a higher incidence of colorectal cancer (CRC), surveillance colonoscopy has resulted in earlier detection of dysplasia and cancer, prompting earlier surgical intervention and improved prognosis, while chemoprevention in the form of the anti-inflammatory 5-aminosalicylate acids and immunosuppression could potentially decrease the incidence of CRC. Numerous extra-intestinal cancers such as hepatobiliary and pancreatic malignancies, however, are also noted to be more prevalent in IBD patients particularly with co-existing primary sclerosing cholangitis. Somewhat ironically, however, the medications used to control the inflammation in IBD may also be responsible for the development of other cancers. The increased risk of lymphoma and skin cancers associated with immunosuppressive medication use may potentially be due to loss of immunosurveillance and in the case of lymphoma, the presence of oncogenic viruses (i.e., Epstein-Barr virus). Thus the challenge for both the treating physician and IBD patient is to balance the risk of any potential treatment against patient symptoms and the natural history of uncontrolled inflammation from their disease.

    M3 - Review article

    VL - 59

    SP - 261

    EP - 272

    JO - Minerva Gastroenterologica e Dietologica

    JF - Minerva Gastroenterologica e Dietologica

    SN - 1121-421X

    IS - 3

    ER -