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 language | English (US) |
|---|---|
| Journal | Liver International |
| DOIs | |
| State | Accepted/In press - 2017 |
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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 journal › Article
}
TY - JOUR
T1 - An update on cancer risk and surveillance in primary sclerosing cholangitis
AU - Horsley-Silva, Jennifer L.
AU - Rodriguez, Eduardo A.
AU - Franco, Diana L.
AU - Lindor, Keith
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
KW - Cancer surveillance
KW - Cholangiocarcinoma
KW - Cirrhosis
KW - Colorectal cancer
KW - Gallbladder cancer
KW - Hepatocellular carcinoma
KW - Primary sclerosing cholangitis
UR - http://www.scopus.com/inward/record.url?scp=85010949830&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85010949830&partnerID=8YFLogxK
U2 - 10.1111/liv.13354
DO - 10.1111/liv.13354
M3 - Article
C2 - 28028930
AN - SCOPUS:85010949830
JO - Liver International
JF - Liver International
SN - 1478-3223
ER -