COLORECTAL CANCER IN INFLAMMATORY BOWEL DISEASE: MYTH OR REALITY IN OUR CONTEXT?

Introduction: Colorectal cancer (CRC) is a major and recognized complication marking the prognosis of inflammatory bowel disease (IBD). The risk factors for its occurrence are the extent of the lesions (pancolitis), the age of the disease and the association with primary sclerosing cholangitis. The aim of this study was to identify the epidemiological, clinical, therapeutic and progressive profile of these patients and to emphasize the importance of surveillance. Methods: This is a retrospective descriptive study which collected all cases of colonic degeneration on IBD followed up within our department. Results: Among the 1388 cases of IBD followed, 6 cases (0.4%) of CRC were collected. The average age of our patients was 52.3 years [38-61 years] with an sex ratio (F / M) of 2. It was an ileocolic Crohn's disease (CD) in one case and ulcerative colitis (CU) in 5 cases (66%) with pancolitis in 4 patients and left colitis in one patient. CRC was discovered during control colonoscopy in 5 known IBD carriers while it was found simultaneously with UC in 1 case. There has been an evolution of more than 10 years in the majority of our patients under anarchic surveillance. No case of associated sclerosing cholangitis was noted. Perendoscopic biopsies confirmed the diagnosis of adenocarcinoma in all cases. After a multidisciplinary consultation meeting, treatment was based on surgery (coloprotectomy) in 5 patients, combined with chemotherapy in one case. One patient was placed on isolated palliative chemotherapy for distant metastases. Conclusion: colon degeneration during IBD is a reality, although its incidence in our context is low (0.4%).