Inflammatory bowel disease-associated colorectal cancer: translational risks from mechanisms to medicines

J Crohns Colitis. 2021 Jun 10;jjab102. doi: 10.1093/ecco-jcc/jjab102. Online ahead of print.

Ross J Porter 1 2, Mark J Arends 3, Antonia M D Churchhouse 2, Shahida Din 2


Author information

  • 1Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Scotland UK.
  • 2NHS Lothian Edinburgh IBD Unit, Western General Hospital, Scotland UK.
  • 3Division of Pathology, Cancer Research UK Edinburgh Centre, Institute of Cancer & Genetics, Western General Hospital, University of Edinburgh, Scotland UK.


The cumulative impact of chronic inflammation in patients with inflammatory bowel diseases predisposes to the development of inflammatory bowel disease-associated colorectal cancer (IBD-CRC). Inflammation can induce mutagenesis and the relapsing-remitting nature of this inflammation, together with epithelial regeneration, may exert selective pressure accelerating carcinogenesis. The molecular pathogenesis of IBD-CRC, termed the 'inflammation-dysplasia-carcinoma' sequence, is well described. However, the immunopathogenesis of IBD-CRC is less well understood. The impact of novel immunosuppressive therapies, which aim to achieve deep remission, is mostly unknown. Therefore, this timely review summarises the clinical context of IBD-CRC, outlines the molecular and immunological basis of disease pathogenesis and considers the impact of novel biologic therapies.



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