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Colorectal cancer surveillance in inflammatory bowel disease: The search continues
Journal article   Open access

Colorectal cancer surveillance in inflammatory bowel disease: The search continues

Anis Ahmadi, Steven Polyak and Peter V Draganov
World journal of gastroenterology : WJG, Vol.15(1), pp.61-66
01/07/2009
DOI: 10.3748/wjg.15.61
PMCID: PMC2653296
PMID: 19115469
url
https://doi.org/10.3748/wjg.15.61View
Published (Version of record) Open Access

Abstract

Patients with inflammatory bowel disease (IBD) are at increased risk for colorectal cancer (CRC). Risk factors for the development of CRC in the setting of IBD include disease duration, anatomic extent of disease, age at time of diagnosis, severity of inflammation, family history of colon cancer, and concomitant primary sclerosing cholangitis. The current surveillance strategy of surveillance colonoscopy with multiple random biopsies most likely reduces morbidity and mortality associated with IBD-related CRC. Unfortunately, surveillance colonoscopy also has severe limitations including high cost, sampling error at time of biopsy, and interobserver disagreement in histologically grading dysplasia. Furthermore, once dysplasia is detected there is disagreement about its management. Advances in endoscopic imaging techniques are already underway, and may potentially aid in dysplasia detection and improve overall surveillance outcomes. Management of dysplasia depends predominantly on the degree and focality of dysplasia, with the mainstay of management involving either proctocolectomy or continued colonoscopic surveillance. Lastly, continued research into additional chemopreventive agents may increase our arsenal in attempting to reduce the incidence of IBD-associated CRC. (C) 2009 The WJG Press and Baishideng. All rights reserved.
 Gastroenterology & Hepatology Life Sciences & Biomedicine Science & Technology

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