Clin Gastroenterol Hepatol. 2024 Jun;22(6):1181-1185.doi: 10.1016/j.cgh.2024.01.030. Epub 2024 Feb 29.

Jordan E Axelrad ¹, David T Rubin ²

Author information

¹Division of Gastroenterology, Department of Medicine, New York University Grossman School of Medicine, New York, New York. Electronic address: Jordan.Axelrad@nyulangone.org.

²Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, Illinois.

Abstract

The inflammatory bowel diseases (IBDs), comprising Crohn’s disease and ulcerative colitis (UC), are chronic inflammatory conditions of the gastrointestinal tract. Individuals with IBD are at an increased risk of developing intestinal neoplasia, particularly colorectal neoplasia (CRN) (including colorectal dysplasia and colorectal cancer [CRC]), as a consequence of chronic colonic inflammation.^– Given that CRC in patients with IBD appears to be preceded by dysplastic changes in the colonic mucosa, prevention strategies to reduce CRC-associated morbidity and mortality have been recommended by multiple society guidelines and independent consensus groups, and include risk assessment, mitigation of inflammation with medical therapies, and screening and surveillance strategies with colonoscopy, with histopathologic assessments at appropriate intervals. Despite these efforts, prevention and management of neoplasia in IBD remains a complex and often confusing topic, requiring careful reappraisal of the evolving evidence base and practicable approaches to clinical practice.