An update on cancer risk and surveillance in primary sclerosing cholangitis

Jennifer L. Horsley-Silva, Eduardo A. Rodriguez, Diana L. Franco, Keith Lindor

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Malignancy represents substantial morbidity and mortality in patients with primary sclerosing cholangitis (PSC). This subset of patients has been proven to be at increased risk for developing cholangiocarcinoma, gallbladder carcinoma and colorectal cancer in those with overlapping inflammatory bowel disease. Herein, we review the prevalence of these malignancies and recommend screening tools and current knowledge to reduce the disease burden in this population. Cholangiocarcinoma is the most dominant malignancy affecting PSC patients, with a lifetime risk ranging from 5% to 20%. We advocate for serial US or MRI/MRCP and CA 19-9 to screen for cholangiocarcinoma. Gallbladder cancer has a lifetime risk around 2% in this population and we agree with annual imaging for lesions as recommended by national guidelines. Patients with PSC and concomitant IBD are at increased risk of colorectal carcinoma from time of diagnosis and therefore should likely undergo annual surveillance. The low rates of hepatocellular cancer and pancreatic cancer indicate surveillance for these malignancies is less advantageous.

Original languageEnglish (US)
JournalLiver International
DOIs
StateAccepted/In press - 2017

Fingerprint

Sclerosing Cholangitis
Cholangiocarcinoma
Gallbladder Neoplasms
Colorectal Neoplasms
Neoplasms
Liver Neoplasms
Pancreatic Neoplasms
Inflammatory Bowel Diseases
Population
Guidelines
Morbidity
Carcinoma
Mortality

Keywords

  • Cancer surveillance
  • Cholangiocarcinoma
  • Cirrhosis
  • Colorectal cancer
  • Gallbladder cancer
  • Hepatocellular carcinoma
  • Primary sclerosing cholangitis

ASJC Scopus subject areas

  • Hepatology

Cite this

An update on cancer risk and surveillance in primary sclerosing cholangitis. / Horsley-Silva, Jennifer L.; Rodriguez, Eduardo A.; Franco, Diana L.; Lindor, Keith.

In: Liver International, 2017.

Research output: Contribution to journalArticle

Horsley-Silva, Jennifer L. ; Rodriguez, Eduardo A. ; Franco, Diana L. ; Lindor, Keith. / An update on cancer risk and surveillance in primary sclerosing cholangitis. In: Liver International. 2017.
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