The relationship between Crohn’s disease (CD) and colorectal cancer (CRC) is still the subject of controversy. These issues are principally epidemiological and statistical, arising from difficulties in interpreting the data from small and heterogeneous series of patients, and as a result, follow up and treatment strategies may differ between centers. Besides this, prognosis of affected patients still remain poor despite of the improvement in survival obtained in the treatment of sporadic CRC. Several case reports and retrospective studies performed in referral centers over different geographic areas of the world have shown, within the last 30 years, an increased risk for the development of CRC in patients with CD (1-5). The extent of disease (extensive colitis), presence of fistula in ano, age of patient (>40 years), strictures and length of disease (>10 years) may be important determinants for increasing risk. In these cases, the risk appears to be similar to that of ulcerative colitis (UC) (2, 6-12). The risk is between 6 and 20 times that of the normal population. Despite this, other population-based studies have shown no increased colon or rectal cancer risk (13-15), but these are open to criticism because of short follow-up and frequent previous surgical resection (11, 16).
The aim of this study is to analyze retrospectively our experience of 296 patients who underwent surgery for colorectal Crohn disease between 1988-2008 and review the literature of the last twenty years, in order to determine risk factors and treatment strategies.