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Prevention of Colorectal Cancer in Inflammatory Bowel Disease Using Advanced Technologies

  • Noa Krugliak Cleveland
  • Jami A. Kinnucan
  • David T. Rubin
Chapter
Part of the Clinical Gastroenterology book series (CG)

Abstract

The risk of colorectal cancer (CRC) among patients with inflammatory bowel disease (IBD) has been well described. The increased risk has been attributed to chronic mucosal inflammation, associated with early disease onset, increased disease duration, extensive mucosal involvement, and concomitant primary sclerosing cholangitis (PSC). Because of this risk, prevention strategies have been recommended and the primary approach to such prevention has been colonoscopic assessment of the mucosa in search of precancerous or early-stage cancerous lesions. Recent developments of advanced visualization techniques such as high-definition colonoscopes and dye-spray chromoendoscopy have provided new options for our approach to prevention. Due to the fact that we now have better visualization techniques, the approach has shifted away from random nontargeted sampling biopsies toward targeted biopsies, active surveillance, and segmental or subtotal resections. In this chapter, we describe the evolving evidence related to cancer prevention in chronic colitis, with an emphasis on newer technologies and how they have changed the approach to detection and follow-up of neoplasia. We propose a rational approach to the incorporation of selective chromoendoscopy and outline the evidence gaps for future study and guideline development.

Keywords

Ulcerative colitis Crohn’s disease Colorectal cancer Dysplasia Neoplasia Surveillance High definition colonoscopy Chromoendoscopy Narrow band imaging 

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Noa Krugliak Cleveland
    • 1
  • Jami A. Kinnucan
    • 2
  • David T. Rubin
    • 3
  1. 1.Department of Medicine, Inflammatory Bowel Disease CenterUniversity of Chicago MedicineChicagoUSA
  2. 2.Department of MedicineUniversity of Michigan Health SystemsAnn ArborUSA
  3. 3.Department of Medicine, Inflammatory Bowel Disease CenterUniversity of Chicago MedicineChicagoUSA

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