Increased colorectal neoplasia in chronic ulcerative colitis complicated by primary sclerosing cholangitis: fact or fiction?

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Abstract
An increased risk of developing colorectal carcinoma in patients with UC was first recognised in the 1920s.1 The magnitude of this risk varies in different studies with a range in cumulative risk after diagnosis in patients with pancolitis of between 1% and 3% at 10 years, 10% at 20 years, and 25% at 35 years.2-5It is now widely accepted that risk factors for malignant transformation are duration of disease and extent of colitis. The presence of graded dysplasia6 or DNA aneuploidy within the colorectal mucosa, and an early age at onset have been described as additional risk factors.4 It has also been suggested that pharmacological therapy of colitis with sulphasalazine or mesalazine may be associated with a reduced incidence of neoplastic transformation.7 , 8

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