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Colitis-Associated Cancer pp 61–83Cite as

Cancer Surveillance of Patients with Long-Standing Inflammatory Bowel Disease

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Abstract

In response to the recognition of the higher risk of cancer in patients with inflammatory bowel disease (IBD), surveillance for those with long-standing disease has become an important tool in detecting and treating neoplastic lesions at an early stage and thus in the reduction of colitis-associated mortality. Most of the recent guidelines agree on the following: (1) For patients with proctosigmoiditis, a regular screening or surveillance colonoscopy program for detecting CRC is not necessary. (2) Surveillance colonoscopy should be started 6–10 years after the onset of symptoms for patients with left-sided or extensive colitis. (3) Ongoing surveillance colonoscopy should be carried out based on the individual risk profile. (4) Two to four random biopsy specimens should be taken every 10 cm along the entire colon, with additional samples acquired in suspicious areas. The random biopsy is now increasingly criticized because of its low yield in detecting neoplasia. In several guidelines, chromoendoscopy with targeted biopsies is an acceptable alternative to white light endoscopy with random biopsy. The value of other newer endoscopic techniques such as narrowband imaging, autofluorescence imaging, and fluorescence endoscopy, with targeted biopsies, remains to be determined.

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  1. Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Yoshiki Okita, Toshimitsu Araki, Koji Tanaka, Yuji Toiyama, Keiichi Uchida & Masato Kusunoki

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    Masato Kusunoki

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Okita, Y., Araki, T., Tanaka, K., Toiyama, Y., Uchida, K., Kusunoki, M. (2016). Cancer Surveillance of Patients with Long-Standing Inflammatory Bowel Disease. In: Kusunoki, M. (eds) Colitis-Associated Cancer. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55522-3_4

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