Observation
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World J Gastroenterol. Oct 7, 2010; 16(37): 4646-4651
Published online Oct 7, 2010. doi: 10.3748/wjg.v16.i37.4646
Surveillance for colitis-associated colon neoplasia
Hugh James Freeman
Hugh James Freeman, Department of Medicine, University of British Columbia, Vancouver, BC V6T 1W5, Canada
Author contributions: Freeman HJ solely contributed to this paper.
Correspondence to: Dr. Hugh James Freeman, MD, CM, FRCPC, FACP, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1W5, Canada. hugfree@shaw.ca
Telephone: +1-604-8227216 Fax: +1-604-8227236
Received: June 12, 2010
Revised: July 18, 2010
Accepted: July 25, 2010
Published online: October 7, 2010
Abstract

The risk of developing colon cancer is increased in colitis patients, particularly if the disease is extensive and its duration long-standing. Endoscopic guidelines have been developed with the goal of detecting early neoplastic changes prior to development of advanced malignancy. Unfortunately, the natural history of this superimposed neoplastic process in colitis appears to be very heterogeneous and poorly understood. Moreover, there are numerous confounding variables in colitis patients that limit accurate assessment of the surveillance effectiveness of colonoscopy and multi-site biopsy protocols. Although the clinical challenge posed to even the most experienced clinicians remains significant, evolving methods of endoscopic imaging may facilitate better evaluation of this highly select group of patients.

Keywords: Ulcerative colitis; Crohn’s disease; Colon cancer; Surveillance colonoscopy; Colon biopsies