| Theme |
Inflammation and cancer in the lower GI tract |
| Title |
Surveillance of Crohn's disease (CD) associated with small bowel cancer (SBC) |
| Author |
Kazuo Ohtsuka |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Kento Takenaka |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Masakazu Nagahori |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Katsuyoshi Matsuoka |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Toshimitsu Fujii |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Eiko Saito |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Mamoru Watanabe |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| [ Summary ] |
Patients with CD have an increased risk of SBC. Although rare by absolute number of cases, this cancer occurs thirty times more frequently in this population than in the general population. Control of intestinal inflammation is considered important for cancer prevention. There are many procedures for small bowel examination, including barium studies, computed tomography (CT), magnetic resonance imaging (MRI), capsule endoscopy, and balloon-assisted endoscopy. However, each procedure has advantages and disadvantages. Barium studies and CT require X-ray exposure. There are few reports about the effectiveness of MRI. Capsule endoscopy cannot be used in stenotic cases. Balloon-assisted endoscopy is used for examination of mucosa and can be used to obtain specimens for pathological examination. However, this is invasive and deep enteroscopy is sometimes difficult. There are no effective cancer surveillance programs at present. Longstanding inflammation is a risk factor for cancer and careful follow-up is necessary. Sudden recurrence in patients whose symptoms were previously stable may be a sign of cancer. |