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June 19, 1981

Dysplasia in Crohn's disease may indicate cancer

JAMA. 1981;245(23):2385. doi:10.1001/jama.1981.03310480009005

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Unequivocal dysplastic changes in patients with Crohn's disease should perhaps be considered an indication for cancer surgery, according to a report from a group at the University of Chicago/the Pritzker School of Medicine.

"It's too early for general recommendations," says Shannon Simpson, MD, a senior resident in pathology, "but the cancer we see in patients with Crohn's disease is especially vicious, so it may be that early surgery is indicated."

Simpson and colleague Robert Riddell, MD, presented a report on intestinal adenocarcinoma and dysplasia in Crohn's disease at the 70th annual meeting of the International Academy of Pathology in Chicago. Simpson said they had studied six patients with both conditions and that adenocarcinoma was found in the ileum, ileocecum, sigmoid, and rectal stump. In one of the six, the cancer was at a previous anastomosis site.

"Intestinal cancer is difficult to detect preoperatively," Simpson noted, "because the x-ray changes resulting