Prevention of colorectal cancer in inflammatory bowel disease: value of screening and 5-aminosalicylates.

Colorectal cancer is a serious complication of inflammatory bowel disease. Given this fact, it is necessary to examine the opportunities for current and future approaches to colorectal cancer prevention. The value of surveillance colonoscopy and chemoprevention of colorectal cancer with 5'-aminosalicylic acid has been evaluated in the recent literature. The current state of knowledge in the epidemiology of and new approaches to the prevention of cancer and dysplasia in inflammatory bowel disease were reviewed. It is concluded that there is significant preclinical and clinical evidence to suggest that 5-aminosalicylate drugs reduce the risk of colorectal neoplasia. However, the minimal dosage to achieve this chemopreventive effect remains unclear. There is also indirect evidence to suggest that surveillance colonoscopy is beneficial for patients with inflammatory bowel disease, particularly in those with long-standing pancolitis or primary sclerosing cholangitis-associated inflammatory bowel disease. However, definitive proof from prospective clinical trials is not available.