Predicting Colorectal Cancer Occurrence in IBD

SIMPLE SUMMARY: Patients with inflammatory bowel disease are at an increased risk of developing colorectal cancer, and so are enrolled in a surveillance colonoscopy programme aimed at detecting and treating any signs of early cancer. This review describes the current known risk factors associated with this increased risk, explores our current molecular understanding of cancer development and reviews potential new methods (molecular and technological) designed to help the surveillance programme. ABSTRACT: Patients with colonic inflammatory bowel disease (IBD) are at an increased risk of developing colorectal cancer (CRC), and are therefore enrolled into a surveillance programme aimed at detecting dysplasia or early cancer. Current surveillance programmes are guided by clinical, endoscopic or histological predictors of colitis-associated CRC (CA-CRC). We have seen great progress in our understanding of these predictors of disease progression, and advances in endoscopic technique and management, along with improved medical care, has been mirrored by the falling incidence of CA-CRC over the last 50 years. However, more could be done to improve our molecular understanding of CA-CRC progression and enable better risk stratification for patients with IBD. This review summarises the known risk factors associated with CA-CRC and explores the molecular landscape that has the potential to complement and optimise the existing IBD surveillance programme.