Surveillance colonoscopy for colitis‐associated dysplasia and cancer in ulcerative colitis patients

Long‐standing ulcerative colitis patients are known to be at a high risk for the development of colorectal cancer. Therefore, surveillance colonoscopy has been recommended for those patients. Because colitis‐associated colorectal cancer may be difficult to identify even by colonoscopy, a random biopsy method has been recommended. However, the procedure of performing a random biopsy is tedious and its effectiveness has also not yet been demonstrated. Instead, targeted biopsy with chromoendoscopy has gained popularity in European and Asian countries. Chromoendoscopy is generally considered to be an effective tool for ulcerative colitis surveillance, which is recommended in the British Society of Gastroenterology and European Crohn's and Colitis Organisation guidelines. Although image enhanced endoscopy, such as narrow band imaging and autofluorescence imaging, has been investigated as a potential ulcerative colitis surveillance tool, it is not routinely applied cable for ulcerative colitis surveillance in its present form. The appropriate intervals of surveillance colonoscopy have yet to be determined. While the Japanese and American guidelines recommend annual or biannual colonoscopy, the British Society of Gastroenterology and European Crohn's and Colitis Organisation stratified their guidelines according to the risks of colorectal cancer. A randomized controlled trial comparing the random and targeted biopsy methods has been conducted in Japan, and while the final analys...

Source: Digestive Endoscopy - May 1, 2015 Category: Gastroenterology Authors: Keisuke Hata, Junko Kishikawa, Hiroyuki Anzai, Takahide Shinagawa, Shinsuke Kazama, Hiroaki Ishii, Hiroaki Nozawa, Kazushige Kawai, Tomomichi Kiyomatsu, Junichiro Tanaka, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Koji Yasuda, Hironori Yamaguchi, Tags: Review Source Type: research