Original article—liver, pancreas, and biliary tractRisk for Colorectal Neoplasia in Patients With Colonic Crohn's Disease and Concomitant Primary Sclerosing Cholangitis
Section snippets
Patients
We studied 166 patients with PSC and colonic inflammatory bowel disease from our database of PSC patients treated in the John Radcliffe Hospital in Oxford. Only PSC patients with established diagnosis of Crohn's disease, ulcerative colitis, or indeterminate colitis were included. Patients with PSC without inflammatory bowel disease or inflammatory bowel disease of less than 5 years were not included in this study. Patients with duration of PSC of less than 3 years were also excluded.
The
Results
Demographic characteristics of the patient groups with inflammatory bowel disease with and without PSC are given in Table 1. The majority of patients with PSC and inflammatory bowel disease were being treated with ursodeoxycholic acid at a daily dose of 15 to 20 mg/kg body weight; 74% of the patients with PSC and Crohn's disease, 82% of patients with PSC and indeterminate colitis, and 79% of the patients with PSC and ulcerative colitis received ursodeoxycholic acid (Table 2). Apart from 1
Discussion
Despite evidence showing that PSC is a risk factor for colorectal cancer in patients with ulcerative colitis4 and that there is increased risk of colorectal cancer in patients with Crohn's disease similar to longstanding ulcerative colitis,12 it is unclear whether PSC is an additional risk factor for colorectal cancer in patients with Crohn's colitis. We have investigated this in the current study by comparing the prevalence of colorectal neoplasia in 5 groups of patients; patients with Crohn's
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2016, Clinical Colorectal CancerCitation Excerpt :Among patients with colonic CD without PSC, 2 developed CRC during follow-up. The presence of PSC did not increase the risk of developing colorectal dysplasia in patients with CD (P = 1.00).48 Also, Loftus et al reported in their study that among IBD subtypes, PSC was more common in UC than CD (80% vs. 10% of cases).49
Cancer Risk and Surveillance in Primary Sclerosing Cholangitis
2016, Clinics in Liver Disease
This article has an accompanying continuing medical education activity on page e31. Learning Objective—At the end of this activity, the learner will identify the risk for the development of colorectal neoplasia in patients with colonic Crohn's disease and concomitant primary sclerosing cholangitis compared to patients with ulcerative colitis and concomitant primary sclerosing cholangitis.
Conflicts of interest The authors disclose no conflicts.