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An update on cancer risk and surveillance in primary sclerosing cholangitis
Author(s) -
HorsleySilva Jennifer L.,
Rodriguez Eduardo A.,
Franco Diana L.,
Lindor Keith D.
Publication year - 2017
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13354
Subject(s) - primary sclerosing cholangitis , medicine , malignancy , colorectal cancer , cancer , population , gastroenterology , concomitant , hepatocellular carcinoma , disease , gallbladder cancer , pancreatic cancer , inflammatory bowel disease , carcinoma , environmental health
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.