Surveillance for colitis-associated colon neoplasia

Table 1 Risk factors for cancer in colitis

Epithelial cell dysplasia (high-grade > low-grade)

Extent of mucosal involvement (pancolitis > distal colitis > proctitis)[3,4]

Extended duration of ongoing disease (> 8-10 yr)[1,2,5]

Severity of histologic inflammation (?linked to compliant 5-ASA use)[6,7]

Onset in childhood (?linked to underlying duration of disease)[3,4,8]

Primary sclerosing cholangitis[9,10]

Liver transplantation, usually for primary sclerosing cholangitis[11-13]

Underlying familial colon cancer risk[14,15]

Other (?immunosuppression, ?biologic agents)

Table 2 Changes positive for dysplasia¹

Nuclear changes	Nuclear enlargement
	Pleomorphism
	Hyperchromatism
	Chromatin fragmentation
	Increased mitotic numbers
	Nuclear stratification
Cellular changes	High nuclear to cytoplasm ratios
	Enlarged nuclei
	Reduced or absent mucus production
Architectural changes	Gland-like arrangement of epithelial cells

¹Dysplasia may be subdivided into low-grade dysplasia and high-grade dysplasia based largely on the nuclear localization in the cells of the epithelial layer. Based on Riddell et al[29].