Short Cut

This article reviewed recent studies investigating the risk of developing inflammatory bowel disease (IBD)-associated CRC, a major potential complication of IBD. In patients with ulcerative colitis (UC) the risk of CRC increases with a younger age of diagnosis (age 0-19 years), longerdisease duration and concomitant primary sclerosing cholangitis. Of note, an underlying genetic predisposition in IBD-associated CRC remains unestablished. Contrary to previous studies, a new population-based cohort study observing 47,347 Danish patients with IBD over 30 years found that CRC risk in patients with crohn's disease was similar to the non-IBD population. Current understanding of the pathophysiology of IBD-associated CRC, predominantly investigated in the mouse model, was explored. Inflammatory mediators driving IBD, including tumour necrosis factor-α and toll-like receptors, may induce the transcription of genes involved in tumorigenesis through activation of nuclear factor κβ. Coexisting dysfunctional p53 signalling may lead to defective apoptosis of these dysplastic cells and progression to CRC. The authors suggest that future research should aim to develop a model topredict the patient-specific risk of developing IBD-associated CRC. This would aid decision makingand assist the targeting of preventative strategies.