World Journal of Gastroenterology Smita Manuscript http://www. wignet.com/esps/ Help Deak: hitp/ / www wgnet com /esps/helpdesk aspx DOE 103788/wjgv228.961 ‘Word J Gastroenterol 2016 January 21; 226): 961-873 ISSN 1007-9327 (print) ISSN2219-2840 (online) (©2016 Bashideng Publishing Group Inc Allright reserved jsease: Global view 2016 Inflammatory Bowel Inflammatory bowel disease associated neoplasia: A surgeon’s perspective Azah A Althumairi, Mark G Lazarey, Susan L Gearhart ‘Azah A Althumairi, Susan L Gearhart, Division of Colorectal Surgery, Department of Surgery, Johns Hopkins University ‘School of Medicine, Baltimore, MD 21287, United States Mark G Lazarev, Division of Gastroenterology, Department fof Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States Author contributions: Althumairi AA performed the study desig, Tterature review, and drafted the manuscript; Gearhart SL drafted the manuscript and performed critical revision and editing; Lazarev MG performed critical revision and editing; all authors approved the final version to be published, Confict-oFnterest statement: fo potential conflict of interest, Open-Access: This article is an open-access article which was selected by an in-house editor and fully pcr-eviewed by extemal reviewers, Its distributed in accordance with the Creative ‘Commons Attribution Non Commercial (CC BY-NC 4.0) license, hie permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on slferent terms, provided the original work is properly cited and the use is non-commercial. See: htsp://ereativecommons.org/ licensestby-ne/4.0) Correspondence to: Susan L Gearhart, MD, Division of Colorectal Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Blalock 618, 600 North Wolfe Street, Baltimore, MD 21287, United States. sdemees @jhmi.edu Telephone: +1-110-9557323, Fax: +1-410-6149866 Received: August 11, 2015 Peer-review started: August 11,2015 First decision: September 29, 2015 Revised: September 30,2015 Accepted: November 19, 2015 Article in press: November 19, 2015 Published online: January 21, 2016 WIG 1 woew.wjgnetcom 961 sista Abstract Inflammatory bowel disease (IBD) is associated with increased risk of colorectal cancer (CRC). The risk is known to increase with longer duration of the disease, family history of CRC, and history of primary sclerosing cholangitis. The diagnosis of the neoplastic changes associated with IBD is difficult owing to the heterogeneous endoscopic appearance and inter- observer variability of the pathological diagnosis. Screening and surveillance guidelines have been established which aim for early detection of neoplasia. Several surgical options are available for the treatment Of IBD-associated neoplasia. Patients’ morbidities, risk factors for CRC, degree and the extent of neoplasia ‘must be considered in choosing the surgical treatment, A multidisciplinary team including the surgeon, gastroenterologist, pathologist, and the patient who has a clear understanding of the nature of their disease Is needed to optimize outcomes. Key words: Inflammatory bowel disease; Dysplasia; Colorectal cancer; Endoscopy; Surveillance; Colectomy © The Author(s) 2016. Published by Balshideng Publishing Group Inc, All rights reserved. Core tip: This review summarizes the natural history of inflammatory bowel disease associated dysplasia and colorectal cancer. An up to date review of risk factors for inflammatory bowel disease associated colorectal ‘cancer is included. Highlights include surgeon specific factors to aid in joint decision making with the patient regarding further management of their disease. These factors include the management options of continued appropriate endoscopic surveillance and the different disease specific surgical options. Finally, it summarizes the long-term surveillance program and the long-term January 21,2016 | Volume 22 | Issue 31World Journal of Gastroenterology Smita Manuscript http://www. wignet.com/esps/ Help Deak: hitp/ / www gnet com /esps/ helpdesk aspx DOE 103788/wig22 204794 ‘Word J Gastroenterol 2016 May 28; 22(20): 4794-4801 ISSN 1007-9327 (prin) ISSN 2219-2840 (online) (©2016 Bashideng Publishing Group Inc Allright reserved jsease: Global view 2016 Inflammatory Bowel Inflammatory bowel disease and cancer: The role of inflammation, immunosuppression, and cancer treatment Jordan E Axelrad, Simon Lichtiger, Vijay Yajnik Jordan E Axelrad, Simon Lichtiger, Department of Medicine, Division of Digestive and Liver Diseases, Columbia University Medical Center, New York, NY 10032, United States Vijay Yajnik, Department of Medicine, Division of Gastro- cnterology, The Massachusetts General Hospital, Boston, MA, (02445, United States Author contributions: Axelrad JE, Lichtiger S and Yajnik V wrote the paper Confict-of interest statement: Authors declare no conflict of interests for this eticle (Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers, Its distributed in accordance with the Creative ‘Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this ‘work non-commercially, and license their derivative works on dierent terms, provided the original work is properly cited and the use is non-commercial. See: hts://ereativecommons.org/ licensea/by-net4.0 Correspondence to: Vijay Yajnik, MD, PhD, Department of Medicine, Division of Gastroenterology, The Massachusetts General Hospital, Crob's and Colitis Center, 165 Cambridge Street 9" Floor, Boston, MA 02445, United States. vyajnik(@mgh harvard.edu Telephone: +1-617-7246005 Fax: +1-617-7263080 Received: February 11,2016 Peer-review started: February 11, 2016 First decision: March 21, 2016 Revised: March 25, 2016 Accepted: April 7, 2016 Article in press: April 7, 2016 Published online: May 28, 2016 shatamye WIG L worw.wignetcom Abstract In patients with inflammatory bowel disease (IBD), chronic inflammation is a major risk factor for the development of gastrointestinal malignancies. The pathogenesis of coltis-associated cancer is distinct from sporadic colorectal carcinoma and the critical ‘molecular mechanisms underlying this process have yet to be elucidated. Patients with IBD have also been shown to be at increased risk of developing extra-intestinal malignancies, Medical therapies that diminish the mucosal inflammatory response represent the foundation of treatment in IBD, and recent evidence supports their introduction earlier in the disease course. However, therapies that alter the immune system, often used for long durations, may also promote carcinogenesis. As the population of patients with IBD grows older, with longer duration Cf chronic inflammation and longer exposure to im- ‘munosuppression, there is an increasing isk of cancer development, Many of these patients will require cancer treatment, including chemotherapy, radiation, hormonal therapy, and surgery. Many patients will require further treatment for their IBD. This review seeks to explore the characteristics and risks of cancer in patients with IBD, and to evaluate the limited data on patients with IBD and cancer, including management of IBD after a diagnosis of cancer, the effects of cancer treatment on IBD, and the effect of IBD and medications for IBD on ‘cancer outcomes, Key words: Inflammatory bowel disease; Cancer; Anti- tumor necrosis factor; Immunosuppression; Chemotherapy; Radiation © The Author(s) 2016. Published by Balshideng Publishing Group Inc, All rights reserved. May 28,2016 | Volume 22 | Issue 20 |