Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jun 27;17(13):2165.
doi: 10.3390/cancers17132165.

Navigating Neoplasm Risk in Inflammatory Bowel Disease and Primary Sclerosing Cholangitis

Demis Pitoni  1   2 , Arianna Dal Buono  1   3 , Roberto Gabbiadini  1 , Vincenzo Ronca  3   4 , Francesca Colapietro  3   4 , Nicola Pugliese  3   4 , Davide Giuseppe Ribaldone  2 , Cristina Bezzio  1   3 , Ana Lleo  3   4 , Alessandro Armuzzi  1   3
Affiliations
Review

Navigating Neoplasm Risk in Inflammatory Bowel Disease and Primary Sclerosing Cholangitis

Demis Pitoni et al. Cancers (Basel). .

Abstract

(1) Background and Aims: Patients with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC) face a significantly increased risk of malignancies, including a 10-fold higher risk for colorectal cancer (CRC) and a lifetime risk for cholangiocarcinoma (CCA) exceeding 20%. The mechanisms underlying this elevated risk remain elusive. This review consolidates recent findings on cancer risk in PSC-IBD patients, focusing on molecular pathways, diagnostic innovations, and prevention strategies. (2) Methods: A comprehensive PubMed search was performed to identify studies published through to March 2025 on oncogenic processes, molecular mechanisms, and advancements in diagnostic and preventive strategies for CRC and CCA in PSC-IBD patients. (3) Results: Surveillance guidelines recommend an annual colonoscopy for CRC and imaging combined with CA 19-9 monitoring for CCA. Recent studies highlight the role of molecular alterations, including epigenetic modifications, in tumorigenesis. Advances in molecular diagnostics, imaging, and endoscopic technologies are improving the accuracy and timeliness of cancer detection. (4) Conclusions: PSC-IBD patients remain at high risk for CRC and CCA, emphasizing the need for vigilant surveillance and advanced prevention strategies. Advances in early detection and precision diagnostics offer new opportunities to reduce the cancer burden in this high-risk population.

Keywords: colorectal cancer; inflammatory bowel disease; neoplasia risk; primary sclerosing cholangitis; surveillance.

PubMed Disclaimer

Conflict of interest statement

A. Armuzzi has received consulting fees from AbbVie, Allergan, Amgen, Arena, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Eli-Lilly, Ferring, Galapagos, Gilead, Janssen, MSD, Mylan, Pfizer, Protagonist Therapeutics, Roche, Samsung Bioepis, Sandoz and Takeda; speaker’s fees from AbbVie, Amgen, Arena, Biogen, Bristol-Myers Squibb, Eli-Lilly, Ferring, Galapagos, Gilead, Janssen, MSD, Novartis, Pfizer, Roche, Samsung Bioepis, Sandoz, Takeda, and Tigenix; and research support from Biogen, MSD, Takeda, and Pfizer. A. Lleo has received consulting fees from Advanz Pharma, GSK, Ipsen, Gilead, and Dr Falk; and speaker fees from Gilead, Abbvie, MSD, Advanz Pharma, AlfaSigma, GSK, Astra Zeneca, Ipsen, and Incyte. She has received travel support and grant support (to Humanitas Research Hospital) from Mirum, GSK, Ipsen, Dr. Falk, and Gilead. C Bezzio has received lecture fees and served as a consultant for Takeda, MSD, Ferring, Abbvie, Galapagos, Celltrion, Janssen, and Eli-Lilly. V. Ronca has received travel support from Ipsen, Falk Foundation, and Orphalan. F. Colapietro has received travel grants from Ipsen and Gilead and a speaker’s fee from Ipsen. R. Gabbiadini has received speaker’s fees from Pfizer, MSD, Eli-Lilly, Janssen, Takeda, and Celltrion. A. Dal Buono has received speaker’s fees from AbbVie, Galapagos, Eli-Lilly, Janssen, and Celltrion, and consulting fees from Ferring. D. Pitoni, N. Pugliese, and D.G. Ribaldone declare no conflicts of interest.

Figures

Figure 1
Figure 1
Pathogenic mechanisms linking PSC and IBD.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Van Munster K.N., Bergquist A., Ponsioen C.Y. Inflammatory Bowel Disease and Primary Sclerosing Cholangitis: One Disease or Two? J. Hepatol. 2024;80:155–168. doi: 10.1016/j.jhep.2023.09.031. - DOI - PubMed
    1. Dyson J.K., Beuers U., Jones D.E.J., Lohse A.W., Hudson M. Primary Sclerosing Cholangitis. Lancet. 2018;391:2547–2559. doi: 10.1016/S0140-6736(18)30300-3. - DOI - PubMed
    1. Boonstra K., Weersma R.K., Van Erpecum K.J., Rauws E.A., Spanier B.W.M., Poen A.C., Van Nieuwkerk K.M., Drenth J.P., Witteman B.J., Tuynman H.A., et al. Population-Based Epidemiology, Malignancy Risk, and Outcome of Primary Sclerosing Cholangitis: Boonstra et Al. Hepatology. 2013;58:2045–2055. doi: 10.1002/hep.26565. - DOI - PubMed
    1. Weismüller T.J., Trivedi P.J., Bergquist A., Imam M., Lenzen H., Ponsioen C.Y., Holm K., Gotthardt D., Färkkilä M.A., Marschall H.-U., et al. Patient Age, Sex, and Inflammatory Bowel Disease Phenotype Associate with Course of Primary Sclerosing Cholangitis. Gastroenterology. 2017;152:1975–1984.e8. doi: 10.1053/j.gastro.2017.02.038. - DOI - PMC - PubMed
    1. Durazzo M., Ferro A., Navarro-Tableros V.M., Gaido A., Fornengo P., Altruda F., Romagnoli R., Moestrup S.K., Calvo P.L., Fagoonee S. Current Treatment Regimens and Promising Molecular Therapies for Chronic Hepatobiliary Diseases. Biomolecules. 2025;15:121. doi: 10.3390/biom15010121. - DOI - PMC - PubMed

LinkOut - more resources