Ulcerative colitis-associated colorectal cancer

World J Gastroenterol. 2014 Nov 28;20(44):16389-97. doi: 10.3748/wjg.v20.i44.16389.


The association between ulcerative colitis (UC) and colorectal cancer (CRC) has been acknowledged. One of the most serious and life threatening consequences of UC is the development of CRC (UC-CRC). UC-CRC patients are younger, more frequently have multiple cancerous lesions, and histologically show mucinous or signet ring cell carcinomas. The risk of CRC begins to increase 8 or 10 years after the diagnosis of UC. Risk factors for CRC with UC patients include young age at diagnosis, longer duration, greater anatomical extent of colonic involvement, the degree of inflammation, family history of CRC, and presence of primary sclerosing cholangitis. CRC on the ground of UC develop from non-dysplastic mucosa to indefinite dysplasia, low-grade dysplasia, high-grade dysplasia and finally to invasive adenocarcinoma. Colonoscopy surveillance programs are recommended to reduce the risk of CRC and mortality in UC. Genetic alterations might play a role in the development of UC-CRC. 5-aminosalicylates might represent a favorable therapeutic option for chemoprevention of CRC.

Keywords: Chemoprevention; Dysplasia; Risk factor; Surveillance colonoscopy; Ulcerative colitis-associated colorectal cancer.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / therapeutic use
  • Anticarcinogenic Agents / therapeutic use
  • Colitis, Ulcerative / complications*
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / drug therapy
  • Colonoscopy
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / etiology*
  • Colorectal Neoplasms / prevention & control
  • Early Detection of Cancer / methods
  • Humans
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors


  • Anti-Inflammatory Agents
  • Anticarcinogenic Agents