Intestinal cancers occurring in patients with Crohn's disease

Background and Aims: The number of patients with Crohn's disease (CD) and the number of cases of intestinal cancer associated with CD have both been increasing in Japan. However, the number of reported cases is lower than for ulcerative colitis-associated cancer. The aim of this study was to identify the clinical picture of CD-associated intestinal cancer in a consecutive series of patients with CD and to stress the importance of surveillance. Methods: We enrolled 174 consecutive patients (130 men, 44 women, mean age 25years) diagnosed with CD and investigated the development of intestinal cancer from October 1998 to July 2010. There were 104 cases of the ileocolitis type, 47 of ileitis, and 23 of colitis. Results: Intestinal cancer developed in two male patients (1.5% of the total), whose respective ages at onset of CD were 41 and 19years, and 55 and 37years at onset of cancer. Both cases were of ileocolitis-type CD; one cancer developed in the rectum and the other in the small bowel, and both were accompanied by severe stricture. Histopathological results revealed well and moderately differentiated adenocarcinoma, respectively. Conclusions: Intestinal cancer developed in patients with ileocolitis-type CD of more than 10years' duration. Our findings suggest that patients with chronic, widespread CD should be under cancer surveillance.