Clin Endosc.  2014 Nov;47(6):509-515. 10.5946/ce.2014.47.6.509.

Colon Cancer Screening and Surveillance in Inflammatory Bowel Disease

• Bae SI
• Kim YS

• KMID: 2134488
• DOI: http://doi.org/10.5946/ce.2014.47.6.509

Abstract

Patients with inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer (CRC). Accordingly, the duration and anatomic extent of the disease have been known to affect the development of IBD-related CRC. When CRC occurs in patients with IBD, unlike in sporadic CRC, it is difficult to detect the lesions because of mucosal changes caused by inflammation. In addition, the tumor types vary with ill-circumscribed lesions, and the cancer is difficult to diagnose and remedy at an early stage. For the diagnosis of CRC in patients with IBD, screening endoscopy is recommended 8 to 10 years after the IBD diagnosis, and surveillance colonoscopy is recommended every 1 to 2 years thereafter. The recent development of targeted biopsies using chromoendoscopy and relatively newer endoscopic techniques helps in the early diagnosis of CRC in patients with IBD. A total proctocolectomy is advisable when high-grade dysplasia or multifocal low-grade dysplasia is confirmed by screening endoscopy or surveillance colonoscopy or if a nonadenoma-like dysplasia-associated lesion or mass is detected. Currently, pharmacotherapies are being extensively studied as a way to prevent IBD-related CRC.

Keyword

Inflammatory bowel diseases; Colonic neoplasms; Surveillance colonoscopy; Chemoprevention

MeSH Terms

Biopsy
Chemoprevention
Colonic Neoplasms*
Colonoscopy
Colorectal Neoplasms
Diagnosis
Drug Therapy
Early Diagnosis
Endoscopy
Humans
Inflammation
Inflammatory Bowel Diseases*
Mass Screening*

Figure

• 

  Fig. 1 A nonadenoma-like dysplasia-associated lesion or mass seen during colon cancer screening in a patient with long-standing ulcerative colitis. Images during conventional (A) white light endoscopy and (B) chromoendoscopy.

• 

  Fig. 2 Algorithm for colorectal cancer screening and surveillance and treatment of dysplasia detected in patients with inflammatory bowel disease. DALM, dysplasia-associated lesion or mass.

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