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A 39-year-old man with ulcerative colitis for 10 years and treated with 5-ASA has also primary sclerosing cholangitis (PSC) for the last 5 years. He has experienced several episodes of cholangitis treated with antibiotics. He had a successful liver transplantation 13 months ago. He is on standard immunosuppressive treatment post liver transplantation as well as continued 5-ASA treatment. There are no gastrointestinal symptoms and normal fecal-calprotectin.

Which of the following statements regarding colorectal cancer risk after liver transplantation in PSC patients is correct?

A. After successful liver transplantation the risk of colorectal cancer is reduced to the background population and surveillance is not necessary

B. There is and increased risk of colorectal cancer and surveillance using fecal hemocult test is recommended annually, and if positive a colonoscopy

C. There is an increased risk of colorectal cancer and surveillance colonoscopy is recommended annually

D. Usually, the immunosuppression for liver transplantation also reduces ulcerative colitis inflammation and 5-ASA can be stopped

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