Cancer surveillance in patients with primary sclerosing cholangitis

Nataliya Razumilava, Gregory J. Gores, Keith D. Lindor

Research output: Contribution to journalReview article

173 Scopus citations

Abstract

Primary sclerosing cholangitis (PSC) is a chronic fibroinflammatory syndrome involving the biliary tract, often accompanied by inflammatory bowel disease (IBD). This syndrome is a prototype disease linking chronic inflammation to carcinogenesis. Indeed, PSC is associated with an increased risk of cholangiocarcinoma (CCA), gallbladder cancer, hepatocellular carcinoma (HCC), and colorectal cancer. Herein, we review the risk for these malignancies in PSC and discuss rational cancer surveillance strategies for these patients. Where evidence is limited, we suggest a pragmatic approach. In this regard, we recommend interval screening for CCA with noninvasive imaging modalities and serum carbohydrate antigen 19-9 determinations annually. These imaging studies also serve to screen for gallbladder cancer and HCC. Screening for colorectal cancer is more firmly established in PSC patients with IBD and includes colonoscopy at the time of PSC diagnosis and, thereafter, at 1-2-year intervals. We also highlight areas where more information is required, such as management of biliary tract dysplasia and cancer chemoprevention in PSC.

Original languageEnglish (US)
Pages (from-to)1842-1852
Number of pages11
JournalHepatology
Volume54
Issue number5
DOIs
StatePublished - Nov 1 2011
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology

Fingerprint Dive into the research topics of 'Cancer surveillance in patients with primary sclerosing cholangitis'. Together they form a unique fingerprint.

  • Cite this