Dimitri Verhulst* Department of Oncology, University of Saint Louis, USA
INTRODUCTION sia is becoming increasingly recognized, but its natural history
is ill-defined and not included in surveillance algorithms. The Colorectal cancer serves as a genetic and biological paradigm concept of cumulative burden of inflammation highlights the for the development of solid tumours, and these findings shed importance of considering histologic inflammation over time as light on the principles of early detection, risk stratification, pre- an important risk factor for CAC. Dysplasia is arguably the most vention, and treatment. Cancer framework features are used important risk factor for developing CAC, and advances have to explore how genetic alterations in colorectal cancer affect been made in endoscopic detection and removal of premalig- the biological properties of cancer cells and shape heterotypic nant lesions, thereby delaying or avoiding surgical resection. interactions between cells within the tumour microenviron- Some of the drugs used to treat IBD are chemopreventive. Bet- ment. It provides a conceptual framework for understanding. ter control of underlying inflammation with new drugs, better This review describes research advances relevant to colorec- endoscopic detection and treatment, more sophisticated as- tal cancer genetics and biology, new concepts gleaned from sessment of clinico pathological risk factors, and colitis-associ- immune and single-cell profiling, key advances and remaining ated tumours, the genetics and immunologicals of colitis, and knowledge gaps. Colorectal cancer is the third most common through increased awareness of environmental causes, asso- cancer worldwide, with an estimated 1.8 million new cases and ciated colorectal tumours will become more predictable and approximately 881,000 deaths worldwide in 2018, making it controllable in the coming years. the second leading cause of cancer-related deaths. There are many causes. The epidemiology of CRC varies greatly by region CONCLUSION of the world. Across different age groups, genders and racial groups. Several factors contribute to this variability, including The development of Artificial Intelligence (AI) algorithms has exposure to risk factors, genetic susceptibility as well as demo- penetrated the medical field with great success. The prolifera- graphic variation, genetic mutations and their impact on prog- tion of AI technology in the diagnosis and treatment of various nosis and response to therapy. types of cancer, especially Colorectal Cancer (CRC), is now a hot topic. CRC is his third most commonly diagnosed malignancy in DESCRIPTION both men and women and is recognized as the leading cause of cancer-related deaths worldwide. The review here aims to Patients with inflammatory bowel disease are at increased risk provide detailed knowledge and analysis of AI applications of developing colorectal cancer, although the incidence of CRC in screening, diagnosis, and treatment of CRC, based on the has decreased in recent years. Chronic inflammation is a driving current literature. We are also investigating the role of recent force in neoplastic progression, resulting in dysplastic precursor advances in AI systems related to medical diagnosis and treat- lesions that can occur in multiple regions of the colon through ment, with some promising results. CRC is a highly accurate- the process of field malignant transformation. Colitis-associat- ly preventable disease, and AI-assisted technology in routine ed CRC shares many molecular similarities with sporadic CRC, screening represents an important step in reducing the inci- and preclinical studies have implicated the microbiome in in- dence of this malignant disease. To this end, computer-assisted teracting with the host immune system in the development of detection and characterization systems are being developed. colitis-associated colorectal cancer. Potential roles are indicat- Moreover, CRC treatment is entering a new era with robotic ed. Several unique molecular differences exist in his CAC, but surgery and new computer-assisted drug delivery techniques. their role in inflammation-associated cancer pathogenesis and At the same time, healthcare is rapidly moving towards preci- behaviour remains to be elucidated. Nonconventional dyspla- sion or personalized medicine.
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