Systemic treatment of patients who have colorectal cancer and inflammatory bowel disease

Inflammatory bowel disease (IBD) is an acknowledged predisposing factor for the development of intestinal and extraintestinal cancers. In general, an increased risk for colorectal cancer exists for patients who have both ulcerative colitis (UC) and Crohn's disease (CD). Small bowel tumors are extremely rare in the general population, but their incidence is enhanced 40-fold in patients who have CD. UC confers a marginally increased risk for myeloid leukemia, whereas patients who have CD may have a trend toward a higher incidence of lymphoma. This article reviews the therapeutic options for the most common malignant complication, colorectal carcinoma, as well as specific recommendations regarding the impact of the underlying disease upon the tolerance and efficacy of chemotherapy in these patients.