Ulcerative colitis and colorectal cancer: Pathogenic insights and precision strategies for prevention and treatment

Table 3 Endoscopic surveillance strategies in inflammatory bowel disease

	Frequency of surveillance
ECCO 2017	Every year (high risk)	PSC or stricture or dysplasia detected within past 5 years or extensive colitis with severe active inflammation or family history of CRC in FDR age < 50
	Every 2-3 years	Extensive colitis with mild or moderate active inflammation or post-inflammatory polyps or family history of CRC in FDR age > 50
	Every 5 years	Absence of intermediate or high-risk features
ACG 2019	Every year	PSC
	Every 1-3 years	UC of any extent beyond the rectum
	Adjust intervals	Based on previous colonoscopies and combined risk factors: Duration of disease, younger age at diagnosis, greater extent of inflammation, FDR with CRC
AGA 2021	Every year	Moderate or severe inflammation (any extent), PSC, family history of CRC in FDR age < 50, dense pseudopolyposis, history of higher-risk visible dysplasia < 5 years ago
	Every 2-3 years	Mild inflammation (any extent), strong family history of CRC (but no FDR age < 50), features of prior severe colitis (moderate pseudopolyps, extensive mucosal scarring), history of invisible dysplasia or higher-risk visible dysplasia > 5 years ago, history of lower risk visible dysplasia < 5 years ago
	Every 5 years	Continuous disease remission since last colonoscopy with mucosal healing on current exam, plus either of: ≥ 2 consecutive exams without dysplasia, minimal historical colitis extent (ulcerative proctitis or < 1/3 of colon in CD)

ECCO: European Crohn’s and Colitis Organisation; ACG: American College of Gastroenterology; AGA: American Gastroenterological Association; PSC: Primary sclerosing cholangitis; CRC: Colorectal cancer; FDR: First degree relative; UC: Ulcerative colitis; CD: Crohn’s disease.