Case 14.3
The patient’s symptoms improved to normal following re-initiation of mesalamine therapy. He is seen in follow up in clinic 6 months later. He reports that his younger brother, who also has ulcerative colitis, was recently diagnosed with colon cancer.
You discuss scheduling him for surveillance colonoscopy. You discuss that patients with inflammatory bowel disease (IBD), specifically with long-standing ulcerative colitis and extensive Crohn’s colitis, have an increased risk of colorectal cancer, approximately two-fold greater than that in the general population.
Which of the following factors most heightens his risk for inflammatory bowel disease-associated dysplasia and colorectal cancer?
Mild degree of inflammation on biopsy
Increased severity of inflammation is associated with increased risk of CRC
Duration of disease less than 10 years
Longer duration of disease is associated with increased risk of CRC
Concomittant Autoimmune Hepatitis
Concomitant primary sclerosing cholangitis, not autoimmune hepatitis, is associated with an increased risk of CRC
Family history of first degree relative with colon cancer
Family history increases this patient's risk of CRC