Journal ArticleDOI
Cancer in Crohn's disease after diversionary surgery: A report of seven carcinomas occurring in excluded bowel
Alexander Greenstein,David B. Sachar,A. Pucillo,Isadore Kreel,S. Geller,Henry D. Janowitz,Arthur H. Aufses +6 more
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Cancer in a bypassed loop should be suspected in any case of Crohn's disease of long duration when a late recrudescence of symptoms occurs, especially when the symptoms are associated with the new appearance of fistula or mass.Abstract:
The incidence of bowel cancer was studied in 132 patients who had undergone bypass surgery for Crohn's disease and who had been admitted to The Mount Sinai Hospital between 1960 and 1976. Seven patients (5.3 per cent) developed cancer (4 of 63 with ileocolitis and 3 of 69 with ileitis). All seven cancers appeared in excluded loops, four in small bowel and three in colon. Six of the cancers occurred at sites of previous active inflammatory disease and one in a relatively normal “skipped” area of cecum. Four were associated with fistulas: two with enterovesical; one with enterocutaneous; and one with both. In only one case was a tumor mass palpable. All seven patients in this series underwent operation and all showed metastatic spread to liver, lymph nodes, or adjacent organs. All patients died within two years of the diagnostic laparotomy. The mean latent period between onset of disease and appearance of cancer was twenty-seven years, and between bypass surgery and appearance of cancer thirteen years. Four of the seven cancers occurred relatively early, within four years of the bypass procedure, but all seven cases had one feature in common—a long duration of Crohn's disease prior to the development of cancer, ranging from seventeen to forty-four years. The diagnosis of cancer in excluded bowel was difficult to make and impossible to confirm prior to laparotomy. Among the large bowel cancers, a preoperative diagnosis was established, by sigmoidoscopy, in only one case. Cancer in a bypassed loop should be suspected in any case of Crohn's disease of long duration when a late recrudescence of symptoms occurs, especially when the symptoms are associated with the new appearance of fistula or mass.read more
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Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002)
Stuart Cairns,John H. Scholefield,Robert Steele,Malcolm G. Dunlop,Huw Thomas,Gareth Evans,Jayne Eaden,Matthew D. Rutter,Wendy P Atkin,Brian P. Saunders,Anneke Lucassen,Paul Jenkins,Peter D. Fairclough,Christopher R J Woodhouse,Ireland +14 more
TL;DR: Advice on the appropriateness, method and frequency of screening for people at moderate and high risk from colorectal cancer and for those with inflammatory bowel disease is provided.
Journal ArticleDOI
Recent developments in nonspecific inflammatory bowel disease (second of two parts).
Joseph B. Kirsner,Roy G. Shorter +1 more
TL;DR: The immune response to these "nonspecific" inflammatory bowel diseases includes ulcerative colitis and proctitis and Crohn's disease of the gastrointestinal tract and its causes and precise relations remain obscure.
Journal ArticleDOI
Cancer in inflammatory bowel disease
Jianlin Xie,Steven H. Itzkowitz +1 more
TL;DR: Patients with long-standing inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer (CRC) and new endoscopic and molecular screening approaches may further refine current surveillance guidelines and the understanding of the natural history of dysplasia.
Journal ArticleDOI
Malignancy in Crohn’s Disease
TL;DR: Cancer morbidity has been evaluated in a series of 513 patients with Crohn's disease under long-term review between 1944-76 and there was no excess of tumours at any site outside the digestive system.
Journal ArticleDOI
A comparison of cancer risk in crohn's disease and ulcerative colitis
TL;DR: The authors estimated cancer risk among 579 patients hospitalized with Crohn's disease between 1960–1976 by calculating the ratios of observed number of cancers (O) in the hospital sample to the expected number of cancer rates (E) based on the age‐ and sex‐specific cancer rates of a standard population.
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