Colorectal cancer and schistosomiasis.

The risk of colorectal cancer is known to be increased in patients with long-standing schistosomal colitis. A retrospective review of clinical data and surgical specimens from 60 patients with schistosomal granulomatous disease of the large intestine but without carcinoma demonstrated that 36 of them had mild to severe grades of colonic epithelial dysplasia. This was either focal or diffuse in distribution and occurred in flat mucosa, in pseudopolyps, or in regenerating epithelium at the edges of ulcers. These dysplastic changes are regarded as the pathological basis for the malignant potential of schistosomal colitis, and they resemble the changes found in long-standing chronic ulcerative colitis.