Colorectal Cancer in Ulcerative Colitis

Colorectal cancer risk in ulcerative colitis is clearly recognized and in about 10% of our patients; the indication for colectomy is the presence of dysplasia on colonoscopic biopsies. In Crohn’s disease, the risk of developing carcinoma of the small bowel has been well described. Although the percentage of patients developing jejunal or ileal cancer is small, the incidence is about 100-fold that of the general population. It is also clear that patients with Crohn’s disease are at increased risk to develop colorectal cancer. It is likely that this risk is similar to that seen in patients with ulcerative colitis and that colonic surveillance with periodic colonoscopy is indicated in patients with Crohn’s disease.