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Endoscopic Surveillance for Neoplasia in IBD: Random Biopsy

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Endoscopy in Inflammatory Bowel Disease

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Abstract

Patients with chronic ulcerative colitis (UC) and Crohn’s colitis have an increased risk of colonic neoplasia and colorectal cancer (CRC). Although data that colonoscopic surveillance programs increase survival is lacking; it is clear that proper surveillance can identify cancer at an earlier stage. It is important to identify which patients should be screened for dysplasia and CRC. Current international guidelines vary with regards to endoscopic techniques, but providers need to be familiar with all endoscopic modalities for optimal dysplasia surveillance. In this chapter we will review the risk factors for CRC in inflammatory bowel disease (IBD), surveillance guidelines and their limitations, and surveillance techniques. For nearly half a century random biopsies using white light endoscopy had been the mainstay of colonic dysplasia surveillance, but growing evidence and rising health care costs have shifted the paradigm toward targeted, contrast enhanced, biopsy techniques.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Gastroenterology, Inflammatory Bowel Disease and Celiac Disease Program, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 4574 JCP, Iowa City, 52242, IA, USA

    Steven Polyak MD

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Editors and Affiliations

  1. Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington, USA

    Richard Kozarek

  2. Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington, USA

    Michael Chiorean

  3. Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA

    Michael Wallace

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ALM polypectomy (MP4 42129 kb)

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Polyak, S. (2015). Endoscopic Surveillance for Neoplasia in IBD: Random Biopsy. In: Kozarek, R., Chiorean, M., Wallace, M. (eds) Endoscopy in Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-11077-6_16

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