Gastrointestinal Cancer

Colorectal cancer (CRC) is the third most commonly diagnosed malignancy in the world. Screening for CRC or its precursor lesions (adenomas) by endoscopy with polypectomy has been shown to reduce CRC incidence and mortality. More vigilant screening and surveillance by colonoscopy is recommended for certain high-risk populations, for example patients with a positive family history of CRC and those with long-existing inflammatory bowel disease. Liver transplant (LT) recipients may potentially be classified as having a CRC risk in the same range as those with a positive family history. Due to improved patient selection, better shortand mid-term outcomes and advances in the post-transplant management of these patients, long-term complications in terms of de novo malignancy become more apparent and clinically relevant. This increased risk for malignancies (such as skin malignancies and post-transplant lymphoproliferative disorder [PTLD]) in LT recipients has been well documented. As a result of these cancer complications in post-LT follow-up, there is more attention on determining the usefulness of neoplasia surveillance programmes in these patients. Whether post-LT patients are also at an increased risk of colorectal cancer is still controversial, and the need for more vigilant or different surveillance programmes for CRC has not been determined. This short article aims to provide the most current evidence on the incidence of CRC in the post-LT setting as well as the usefulness of pre-transplant colorectal cancer screening in an LT candidate.