Colorectal Cancer in Inflammatory Bowel Disease
Patients with inflammatory bowel disease (IBD) affecting the colon are at increased risk of developing colorectal cancer (CRC) compared to the general population. Both duration and extent of colitis are important risk factors for CRC, as is the presence of primary sclerosing cholangitis (PSC), family history of CRC, and (in some studies) early age at diagnosis of colitis. Efforts to reduce this risk have focused on colonoscopic surveillance as the best alternative to the more definitive but less appealing approach of prophylactic colectomy. Though surveillance has benefits that probably include decreased CRC mortality, its efficacy has not been firmly established and is limited by problems of patient dropout, sampling error when too few biopsies are taken at endoscopy, and difficulty in histopathological interpretation of dysplasia. High false negative rates at endoscopy have led to the recommendation that colectomy be considered for dysplasia of any grade.
KeywordsUlcerative Colitis Primary Sclerosing Cholangitis Inflammatory Bowel Disease Patient Total Proctocolectomy High False Negative Rate
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