Abstract
Colorectal cancer has become one of the most prevalent malignant diseases for both men and women. Patients with inflammatory bowel diseases or certain inherited cancer syndromes are at high risk of developing colorectal cancer and have naturally the highest need for cancer prevention. In familial adenomatous polyposis (FAP) and Lynch syndrome, most of the underlying germline mutations can be detected by DNA sequencing, and medical counselling of affected individuals involves both surveillance tests and chemopreventive measures. However, as the mechanisms leading to colorectal cancer differ in these high-risk groups, the molecular action of chemopreventive drugs needs to be adjusted to the certain pathway of carcinogenesis. In the last decades, a number of drugs have been tested, including sulindac, aspirin, celecoxib, and mesalazine, but some of them are still controversially discussed. This review summarizes the advances and current standards of colorectal cancer prevention in patients with inflammatory bowel disease, FAP and Lynch syndrome.
References
1.
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM: Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-2917.
2.
Lutgens MW, van Oijen MG, van der Heijden GJ, Vleggaar FP, Siersema PD, Oldenburg B: Declining risk of colorectal cancer in inflammatory bowel disease: an updated meta-analysis of population-based cohort studies. Inflamm Bowel Dis 2013;19:789-799.
3.
Jess T, Rungoe C, Peyrin-Biroulet L: Risk of colorectal cancer in patients with ulcerative colitis: a meta-analysis of population-based cohort studies. Clin Gastroenterol Hepatol 2012;10:639-645.
4.
Rubin DT, Cruz-Correa MR, Gasche C, Jass JR, Lichtenstein GR, Montgomery EA, Riddell RH, Rutter MD, Ullman TA, Velayos FS, Itzkowitz S; 5-ASA in Colorectal Cancer Prevention Meeting Group: Colorectal cancer prevention in inflammatory bowel disease and the role of 5-aminosalicylic acid: a clinical review and update. Inflamm Bowel Dis 2008;14:265-274.
5.
Andrews JM, Travis SP, Gibson PR, Gasche C: Systematic review: does concurrent therapy with 5-ASA and immunomodulators in inflammatory bowel disease improve outcomes? Aliment Pharmacol Ther 2009;29:459-469.
6.
Eaden JA, Abrams KR, Mayberry JF: The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut 2001;48:526-535.
7.
Jess T, Gamborg M, Matzen P, Munkholm P, Sorensen TI: Increased risk of intestinal cancer in Crohn's disease: a meta-analysis of population-based cohort studies. Am J Gastroenterol 2005;100:2724-2729.
8.
Canavan C, Abrams KR, Mayberry J: Meta-analysis: colorectal and small bowel cancer risk in patients with Crohn's disease. Aliment Pharmacol Ther 2006;23:1097-1104.
9.
Jess T, Simonsen J, Jorgensen KT, Pedersen BV, Nielsen NM, Frisch M: Decreasing risk of colorectal cancer in patients with inflammatory bowel disease over 30 years. Gastroenterology 2012;143:375-381, quiz e13-14.
10.
Langholz E, Munkholm P, Davidsen M, Binder V: Colorectal cancer risk and mortality in patients with ulcerative colitis. Gastroenterology 1992;103:1444-1451.
11.
Ahnfelt-Ronne I, Nielsen OH, Christensen A, Langholz E, Binder V, Riis P: Clinical evidence supporting the radical scavenger mechanism of 5-aminosalicylic acid. Gastroenterology 1990;98:1162-1169.
12.
Koelink PJ, Hawinkels LJ, Wiercinska E, Sier CF, ten Dijke P, Lamers CB, Hommes DW, Verspaget HW: 5-aminosalicylic acid inhibits TGF-β1 signalling in colorectal cancer cells. Cancer Lett 2010;287:82-90.
13.
Kaiser GC, Yan F, Polk DB: Mesalamine blocks tumor necrosis factor growth inhibition and nuclear factor kappaB activation in mouse colonocytes. Gastroenterology 1999;116:602-609.
14.
Swidsinski A, Loening-Baucke V, Bengmark S, Lochs H, Dorffel Y: Azathioprine and mesalazine-induced effects on the mucosal flora in patients with IBD colitis. Inflamm Bowel Dis 2007;13:51-56.
15.
Reinacher-Schick A, Seidensticker F, Petrasch S, Reiser M, Philippou S, Theegarten D, Freitag G, Schmiegel W: Mesalazine changes apoptosis and proliferation in normal mucosa of patients with sporadic polyps of the large bowel. Endoscopy 2000;32:245-254.
16.
Lyakhovich A, Michlmayr A, Bakulina A, Gerner C, Oehler R, Gasche C: Interaction of mesalazine (5-ASA) with translational initiation factors eIF4 partially explains 5-ASA anti-inflammatory and anti-neoplastic activities. Med Chem 2011;7:92-98.
17.
Luciani MG, Campregher C, Fortune JM, Kunkel TA, Gasche C: 5-ASA affects cell cycle progression in colorectal cells by reversibly activating a replication checkpoint. Gastroenterology 2007;132:221-235.
18.
Gasche C, Goel A, Natarajan L, Boland CR: Mesalazine improves replication fidelity in cultured colorectal cells. Cancer Res 2005;65:3993-3997.
19.
Campregher C, Honeder C, Chung H, Carethers JM, Gasche C: Mesalazine reduces mutations in transforming growth factor β-receptor II and activin type II receptor by improvement of replication fidelity in mononucleotide repeats. Clin Cancer Res 2010;16:1950-1956.
20.
Campregher C, Kortüm B, Pinter M, Lang M, Evstatiev R, Khare V, Kucherlapati MH, Edelmann W, Gasche C: Mesalazine decreases microsatellite instability and tumor development in the Villin-Cre Msh2loxp/Loxp mouse model of Lynch syndrome. Gastroenterology 2013;144:S-18.
21.
Khare V, Lang M, Dammann K, Campregher C, Lyakhovich A, Gasche C: Modulation of N-glycosylation by mesalamine facilitates membranous E-cadherin expression in colon epithelial cells. Biochem Pharmacol 2014;87:312-320.
22.
Khare V, Lyakhovich A, Dammann K, Lang M, Borgmann M, Tichy B, Pospisilova S, Luciani G, Campregher C, Evstatiev R, Pflueger M, Hundsberger H, Gasche C: Mesalamine modulates intercellular adhesion through inhibition of p-21 activated kinase-1. Biochem Pharmacol 2013;85:234-244.
23.
Velayos FS, Terdiman JP, Walsh JM: Effect of 5-aminosalicylate use on colorectal cancer and dysplasia risk: a systematic review and meta-analysis of observational studies. Am J Gastroenterol 2005;100:1345-1353.
24.
van Staa TP, Card T, Logan RF, Leufkens HG: 5-aminosalicylate use and colorectal cancer risk in inflammatory bowel disease: a large epidemiological study. Gut 2005;54:1573-1578.
25.
Bernstein CN, Nugent Z, Blanchard JF: 5-aminosalicylate is not chemoprophylactic for colorectal cancer in IBD: a population-based study. Am J Gastroenterol 2011;106:731-736.
26.
Nguyen GC, Gulamhusein A, Bernstein CN: 5-aminosalicylic acid is not protective against colorectal cancer in inflammatory bowel disease: a meta-analysis of non-referral populations. Am J Gastroenterol 2012;107:1298-1304, quiz 1297, 1305.
27.
Tiede I, Fritz G, Strand S, Poppe D, Dvorsky R, Strand D, Lehr HA, Wirtz S, Becker C, Atreya R, Mudter J, Hildner K, Bartsch B, Holtmann M, Blumberg R, Walczak H, Iven H, Galle PR, Ahmadian MR, Neurath MF: CD28-dependent Rac1 activation is the molecular target of azathioprine in primary human CD4+ T lymphocytes. J Clin Invest 2003;111:1133-1145.
28.
van Schaik FD, van Oijen MG, Smeets HM, van der Heijden GJ, Siersema PD, Oldenburg B: Thiopurines prevent advanced colorectal neoplasia in patients with inflammatory bowel disease. Gut 2012;61:235-240.
29.
Gong J, Zhu L, Guo Z, Li Y, Zhu W, Li N, Li J: Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis. PloS One 2013;8:e81487.
30.
Beaugerie L, Svrcek M, Seksik P, Bouvier AM, Simon T, Allez M, Brixi H, Gornet JM, Altwegg R, Beau P, Duclos B, Bourreille A, Faivre J, Peyrin-Biroulet L, Flejou JF, Carrat F, CESAME Study Group: Risk of colorectal high-grade dysplasia and cancer in a prospective observational cohort of patients with inflammatory bowel disease. Gastroenterology 2013;145:166-175.
31.
Peyrin-Biroulet L, Khosrotehrani K, Carrat F, Bouvier AM, Chevaux JB, Simon T, Carbonnel F, Colombel JF, Dupas JL, Godeberge P, Hugot JP, Lemann M, Nahon S, Sabate JM, Tucat G, Beaugerie L, Cesame Study G: Increased risk for nonmelanoma skin cancers in patients who receive thiopurines for inflammatory bowel disease. Gastroenterology 2011;141:1621-1628.
32.
Long MD, Herfarth HH, Pipkin CA, Porter CQ, Sandler RS, Kappelman MD: Increased risk for non-melanoma skin cancer in patients with inflammatory bowel disease. Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association 2010;8:268-274.
33.
van Schaik FD, van Oijen MG, Smeets HM, van der Heijden GJ, Siersema PD, Oldenburg B: Risk of nonmelanoma skin cancer in patients with inflammatory bowel disease who use thiopurines is not increased. Clin Gastroenterol Hepatol 2011;9:449-450, author reply 450-451.
34.
Armstrong RG, West J, Card TR: Risk of cancer in inflammatory bowel disease treated with azathioprine: a UK population-based case-control study. Am J Gastroenterol 2010;105:1604-1609.
35.
Pasternak B, Svanstrom H, Schmiegelow K, Jess T, Hviid A: Use of azathioprine and the risk of cancer in inflammatory bowel disease. Am J Epidemiol 2013;177:1296-1305.
36.
Lv R, Qiao W, Wu Z, Wang Y, Dai S, Liu Q, Zheng X: Tumor necrosis factor alpha blocking agents as treatment for ulcerative colitis intolerant or refractory to conventional medical therapy: a meta-analysis. PloS One 2014;9:e86692.
37.
Caspersen S, Elkjaer M, Riis L, Pedersen N, Mortensen C, Jess T, Sarto P, Hansen TS, Wewer V, Bendtsen F, Moesgaard F, Munkholm P, Danish Crohn Colitis D: Infliximab for inflammatory bowel disease in Denmark 1999-2005: clinical outcome and follow-up evaluation of malignancy and mortality. Clin Gastroenterol Hepatol 2008;6:1212-1217, quiz 1176.
38.
Osterman MT, Sandborn WJ, Colombel JF, Robinson AM, Lau W, Huang B, Pollack PF, Thakkar RB, Lewis JD: Increased risk of malignancy with adalimumab combination therapy, compared to monotherapy, for Crohn's disease. Gastroenterology 2014;146:941-949.
39.
Brentnall TA, Haggitt RC, Rabinovitch PS, Kimmey MB, Bronner MP, Levine DS, Kowdley KV, Stevens AC, Crispin DA, Emond M, Rubin CE: Risk and natural history of colonic neoplasia in patients with primary sclerosing cholangitis and ulcerative colitis. Gastroenterology 1996;110:331-338.
40.
Pardi DS, Loftus EV Jr, Kremers WK, Keach J, Lindor KD: Ursodeoxycholic acid as a chemopreventive agent in patients with ulcerative colitis and primary sclerosing cholangitis. Gastroenterology 2003;124:889-893.
41.
Tung BY, Emond MJ, Haggitt RC, Bronner MP, Kimmey MB, Kowdley KV, Brentnall TA: Ursodiol use is associated with lower prevalence of colonic neoplasia in patients with ulcerative colitis and primary sclerosing cholangitis. Ann Intern Med 2001;134:89-95.
42.
Lindstrom L, Boberg KM, Wikman O, Friis-Liby I, Hultcrantz R, Prytz H, Sandberg-Gertzen H, Sangfelt P, Rydning A, Folvik G, Gangsoy-Kristiansen M, Danielsson A, Bergquist A: High dose ursodeoxycholic acid in primary sclerosing cholangitis does not prevent colorectal neoplasia. Aliment Pharmacol Ther 2012;35:451-457.
43.
Eaton JE, Silveira MG, Pardi DS, Sinakos E, Kowdley KV, Luketic VA, Harrison ME, McCashland T, Befeler AS, Harnois D, Jorgensen R, Petz J, Lindor KD: High-dose ursodeoxycholic acid is associated with the development of colorectal neoplasia in patients with ulcerative colitis and primary sclerosing cholangitis. Am J Gastroenterol 2011;106:1638-1645.
44.
Wolf JM, Rybicki LA, Lashner BA: The impact of ursodeoxycholic acid on cancer, dysplasia and mortality in ulcerative colitis patients with primary sclerosing cholangitis. Aliment Pharmacol Ther 2005;22:783-788.
45.
Hansen JD, Kumar S, Lo WK, Poulsen DM, Halai UA, Tater KC: Ursodiol and colorectal cancer or dysplasia risk in primary sclerosing cholangitis and inflammatory bowel disease: a meta-analysis. Dig Dis Sci 2013;58:3079-3087.
46.
Parc Y, Desaint B, Flejou JF, Lefevre JH, Serfaty L, Vienne A, Kotti S, Simon T, Tiret E: The effect of ursodesoxycholic acid on duodenal adenomas in familial adenomatous polyposis: A prospective randomized placebo-control trial. Colorectal Dis 2012;14:854-860.
47.
Lamlum H, Ilyas M, Rowan A, Clark S, Johnson V, Bell J, Frayling I, Efstathiou J, Pack K, Payne S, Roylance R, Gorman P, Sheer D, Neale K, Phillips R, Talbot I, Bodmer W, Tomlinson I: The type of somatic mutation at APC in familial adenomatous polyposis is determined by the site of the germline mutation: a new facet to Knudson's ‘two-hit' hypothesis. Nat Med 1999;5:1071-1075.
48.
Stolfi C, De Simone V, Pallone F, Monteleone G: Mechanisms of action of non-steroidal anti-inflammatory drugs (NSAIDS) and mesalazine in the chemoprevention of colorectal cancer. Int J Mol Sci 2013;14:17972-17985.
49.
Bresalier RS, Sandler RS, Quan H, Bolognese JA, Oxenius B, Horgan K, Lines C, Riddell R, Morton D, Lanas A, Konstam MA, Baron JA; Adenomatous Polyp Prevention on Vioxx Trial I: cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. New Engl J Med 2005;352:1092-1102.
50.
Labayle D, Fischer D, Vielh P, Drouhin F, Pariente A, Bories C, Duhamel O, Trousset M, Attali P: Sulindac causes regression of rectal polyps in familial adenomatous polyposis. Gastroenterology 1991;101:635-639.
51.
Giardiello FM, Hamilton SR, Krush AJ, Piantadosi S, Hylind LM, Celano P, Booker SV, Robinson CR, Offerhaus GJ: Treatment of colonic and rectal adenomas with sulindac in familial adenomatous polyposis. New Engl J Med 1993;328:1313-1316.
52.
Nugent KP, Farmer KC, Spigelman AD, Williams CB, Phillips RK: Randomized controlled trial of the effect of sulindac on duodenal and rectal polyposis and cell proliferation in patients with familial adenomatous polyposis. Br J Surg 1993;80:1618-1619.
53.
Spagnesi MT, Tonelli F, Dolara P, Caderni G, Valanzano R, Anastasi A, Bianchini F: Rectal proliferation and polyp occurrence in patients with familial adenomatous polyposis after sulindac treatment. Gastroenterology 1994;106:362-366.
54.
Winde G, Gumbinger HG, Osswald H, Kemper F, Bunte H: The NSAID sulindac reverses rectal adenomas in colectomized patients with familial adenomatous polyposis: clinical results of a dose-finding study on rectal sulindac administration. Int J Colorectal Dis 1993;8:13-17.
55.
Winde G, Schmid KW, Schlegel W, Fischer R, Osswald H, Bunte H: Complete reversion and prevention of rectal adenomas in colectomized patients with familial adenomatous polyposis by rectal low-dose sulindac maintenance treatment. Advantages of a low-dose nonsteroidal anti-inflammatory drug regimen in reversing adenomas exceeding 33 months. Dis Colon Rectum 1995;38:813-830.
56.
Giardiello FM, Yang VW, Hylind LM, Krush AJ, Petersen GM, Trimbath JD, Piantadosi S, Garrett E, Geiman DE, Hubbard W, Offerhaus GJ, Hamilton SR: Primary chemoprevention of familial adenomatous polyposis with sulindac. New Eng J Med 2002;346:1054-1059.
57.
Cruz-Correa M, Hylind LM, Romans KE, Booker SV, Giardiello FM: Long-term treatment with sulindac in familial adenomatous polyposis: a prospective cohort study. Gastroenterology 2002;122:641-645.
58.
Tonelli F, Valanzano R, Messerini L, Ficari F: Long-term treatment with sulindac in familial adenomatous polyposis: is there an actual efficacy in prevention of rectal cancer? J Surg Oncol 2000;74:15-20.
59.
Guldenschuh I, Hurlimann R, Muller A, Ammann R, Mullhaupt B, Dobbie Z, Zala GF, Flury R, Seelentag W, Roth J, Meyenberger C, Fried M, Hoppeler T, Spigelman AD, Scott RJ: Relationship between APC genotype, polyp distribution, and oral sulindac treatment in the colon and rectum of patients with familial adenomatous polyposis. Dis Colon Rectum 2001;44:1090-1097, discussion 1097-1099.
60.
Matsumoto T, Nakamura S, Esaki M, Yao T, Iida M: Effect of the non-steroidal anti-inflammatory drug sulindac on colorectal adenomas of uncolectomized familial adenomatous polyposis. J Gastroenterol Hepatol 2006;21:251-257.
61.
Lynch HT, Thorson AG, Smyrk T: Rectal cancer after prolonged sulindac chemoprevention. A case report. Cancer 1995;75:936-938.
62.
Shaheen NJ, Straus WL, Sandler RS: Chemoprevention of gastrointestinal malignancies with nonsteroidal anti-inflammatory drugs. Cancer 2002;94:950-963.
63.
Burn J, Bishop DT, Chapman PD, Elliott F, Bertario L, Dunlop MG, Eccles D, Ellis A, Evans DG, Fodde R, Maher ER, Moslein G, Vasen HF, Coaker J, Phillips RK, Bulow S, Mathers JC; International CAPP Consortium: A randomized placebo-controlled prevention trial of aspirin and/or resistant starch in young people with familial adenomatous polyposis. Cancer Prev Res 2011;4:655-665.
64.
Ishikawa H, Wakabayashi K, Suzuki S, Mutoh M, Hirata K, Nakamura T, Takeyama I, Kawano A, Gondo N, Abe T, Tokudome S, Goto C, Matsuura N, Sakai T: Preventive effects of low-dose aspirin on colorectal adenoma growth in patients with familial adenomatous polyposis: double-blind, randomized clinical trial. Cancer Med 2013;2:50-56.
65.
Steinbach G, Lynch PM, Phillips RK, Wallace MH, Hawk E, Gordon GB, Wakabayashi N, Saunders B, Shen Y, Fujimura T, Su LK, Levin B, Godio L, Patterson S, Rodriguez-Bigas MA, Jester SL, King KL, Schumacher M, Abbruzzese J, DuBois RN, Hittelman WN, Zimmerman S, Sherman JW, Kelloff G: The effect of celecoxib, a cyclooxygenase-2 inhibitor, in familial adenomatous polyposis. New Engl J Med 2000;342:1946-1952.
66.
Phillips RK, Wallace MH, Lynch PM, Hawk E, Gordon GB, Saunders BP, Wakabayashi N, Shen Y, Zimmerman S, Godio L, Rodrigues-Bigas M, Su LK, Sherman J, Kelloff G, Levin B, Steinbach G; FAP Study Group: A randomised, double blind, placebo controlled study of celecoxib, a selective cyclooxygenase 2 inhibitor, on duodenal polyposis in familial adenomatous polyposis. Gut 2002;50:857-860.
67.
Lynch PM, Ayers GD, Hawk E, Richmond E, Eagle C, Woloj M, Church J, Hasson H, Patterson S, Half E, Burke CA: The safety and efficacy of celecoxib in children with familial adenomatous polyposis. Am J Gastroenterol 2010;105:1437-1443.
68.
Iwama T, Akasu T, Utsunomiya J, Muto T: Does a selective cyclooxygenase-2 inhibitor (tiracoxib) induce clinically sufficient suppression of adenomas in patients with familial adenomatous polyposis? A randomized double-blind placebo-controlled clinical trial. Int J Clin Oncol 2006;11:133-139.
69.
Vasen HF, Blanco I, Aktan-Collan K, et al: Revised guidelines for the clinical management of Lynch syndrome (HNPCC): recommendations by a group of European experts. Gut 2013;62:812-823.
70.
Mecklin JP: Frequency of hereditary colorectal carcinoma. Gastroenterology 1987;93:1021-1025.
71.
De Jong AE, Morreau H, Van Puijenbroek M, Eilers PH, Wijnen J, Nagengast FM, Griffioen G, Cats A, Menko FH, Kleibeuker JH, Vasen HF: The role of mismatch repair gene defects in the development of adenomas in patients with HNPCC. Gastroenterology 2004;126:42-48.
72.
Lynch HT, Lanspa S, Smyrk T, Boman B, Watson P, Lynch J: Hereditary nonpolyposis colorectal cancer (Lynch syndromes I and II). Genetics, pathology, natural history, and cancer control. Part I. Cancer Genet Cytogenet 1991;53:143-160.
73.
Burn J, Bishop DT, Mecklin JP, et al: CAPP2 Investigators: Effect of aspirin or resistant starch on colorectal neoplasia in the Lynch syndrome. New Engl J Med 2008;359:2567-2578.
74.
Mathers JC, Movahedi M, Macrae F, et al; CAPP2 Investigators: Long-term effect of resistant starch on cancer risk in carriers of hereditary colorectal cancer: an analysis from the CAPP2 randomised controlled trial. Lancet Oncol 2012;13:1242-1249.
75.
Burn J, Mathers JC, Bishop DT: Chemoprevention in Lynch syndrome. Fam Cancer 2013;12:707-718.
76.
Gasche C, Möslein G, Vasen HF, Lubinski J, Karner-Hanusch J, Niv Y: MesaCAPP: Mesalamine for Colorectal Cancer Prevention Program in Lynch Syndrome. http://www.transcanfp7.eu/transcan/file.php/1/Calls/JTC-2012/Selected_projects/CANCER12-MesaCapp.pdf.
77.
Irving GR, Karmokar A, Berry DP, Brown K, Steward WP: Curcumin: the potential for efficacy in gastrointestinal diseases. Best Pract Res Clin Gastroenterol 2011;25:519-534.
78.
Hull MA: Omega-3 polyunsaturated fatty acids. Best Pract Res Clin Gastroenterol 2011;25:547-554.
79.
West NJ, Clark SK, Phillips RK, Hutchinson JM, Leicester RJ, Belluzzi A, Hull MA: Eicosapentaenoic acid reduces rectal polyp number and size in familial adenomatous polyposis. Gut 2010;59:918-925.
80.
DeCosse JJ, Adams MB, Kuzma JF, LoGerfo P, Condon RE: Effect of ascorbic acid on rectal polyps of patients with familial polyposis. Surgery 1975;78:608-612.
81.
Bussey HJ, DeCosse JJ, Deschner EE, Eyers AA, Lesser ML, Morson BC, Ritchie SM, Thomson JP, Wadsworth J: A randomized trial of ascorbic acid in polyposis coli. Cancer 1982;50:1434-1439.
82.
DeCosse JJ, Miller HH, Lesser ML: Effect of wheat fiber and vitamins C and E on rectal polyps in patients with familial adenomatous polyposis. J Natl Cancer Inst 1989;81:1290-1297.
83.
Thomas MG, Thomson JP, Williamson RC: Oral calcium inhibits rectal epithelial proliferation in familial adenomatous polyposis. Br J Surg 1993;80:499-501.
84.
Lashner BA, Provencher KS, Seidner DL, Knesebeck A, Brzezinski A: The effect of folic acid supplementation on the risk for cancer or dysplasia in ulcerative colitis. Gastroenterology 1997;112:29-32.
85.
Cruz-Correa M, Shoskes DA, Sanchez P, Zhao R, Hylind LM, Wexner SD, Giardiello FM: Combination treatment with curcumin and quercetin of adenomas in familial adenomatous polyposis. Clin Gastroenterol Hepatol 2006;4:1035-1038.
86.
van Heumen BW, Roelofs HM, Vink-Borger ME, Dekker E, Mathus-Vliegen EM, Dees J, Koornstra JJ, Langers AM, Nagtegaal ID, Kampman E, Peters WH, Nagengast FM: Ursodeoxycholic acid counteracts celecoxib in reduction of duodenal polyps in patients with familial adenomatous polyposis: a multicentre, randomized controlled trial. Orphanet J Rare Dis 2013;8:118.
87.
Groen EJ, Roos A, Muntinghe FL, Enting RH, de Vries J, Kleibeuker JH, Witjes MJ, Links TP, van Beek AP: Extra-intestinal manifestations of familial adenomatous polyposis. Ann Surg Oncol 2008;15:2439-2450.
88.
Half E, Bercovich D, Rozen P: Familial adenomatous polyposis. Orphanet J Rare Dis 2009;4:22.
89.
Anaya DA, Chang GJ, Rodriguez-Bigas MA: Extracolonic manifestations of hereditary colorectal cancer syndromes. Clin Colon Rectal Surg 2008;21:263-272.
90.
Rubenstein JH, Waljee AK, Jeter JM, Velayos FS, Ladabaum U, Higgins PD: Cost effectiveness of ulcerative colitis surveillance in the setting of 5-aminosalicylates. Am J Gastroenterol 2009;104:2222-2232.
© 2014 S. Karger AG, Basel
2014
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
