Colorectal cancer surveillance in inflammatory bowel disease: Practice guidelines and recent developments

Table 1 Societal recommendations for colorectal cancer surveillance

Society	Surveillance intervals
ACG (UC) 2019[46]	Every 1-3 yr		Every year PSC
	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, first-degree relative with CRC
AGA 2010[2]	Every 1-2 yr	More frequent surveillance	Every year
	Extensive or left sided colitis.	Ongoing endoscopic or histologic inflammation or History CRC in first degree relative or Anatomic abnormality i.e., foreshortened colon, stricture or inflammatory pseudopolyps	PSC
	Every 1-3 yr
	After two negative exams
ASGE 2015	Beyond every 3 yr	Every 1-3 yr	Every year
	Endoscopically and histologically normal on two or more surveillance colonoscopies	Average risk	PSC or Active inflammation or History of dysplasia or History CRC in first degree relative or Anatomic abnormality i.e., stricture, multiple pseudopolyps
BSG 2010[30]	Every 5 yr	Every 3 yr	Every year
	Lower risk	Intermediate risk	Higher risk
	Extensive colitis with no active endoscopic or histologic inflammation or Left-sided colitis or Crohn’s colitis with < 50% involvement	Extensive colitis with mild active endoscopic or histologic inflammation or Family history CRC in first degree relative > 50 or Post-inflammatory polyps	Extensive colitis with moderate to severe active endoscopic or histologic inflammation or PSC or Stricture in past 5 yr or Dysplasia in past 5 yr without surgery or Family history CRC in first degree relative < 50
ECCO 2017[32]	Every 5 yr	Every 2-3 yr	Every Year
	Absence of intermediate or high risk features	Intermediate risk	High risk
		Extensive colitis with mild or moderate active inflammation or Post-inflammatory polyps or Family history CRC in first degree relative > 50	PSC or Stricture or dysplasia detected within past 5 yr or Extensive colitis with severe active inflammation or Family history CRC in first degree relative < 50
NICE 2011[76]	Every 5 yrLow risk	Every 3 yrIntermediate risk	Every yearHigh risk
	Extensive but quiescent UC or Crohn’s colitis or Left sided UC or Crohn’s colitis	Extensive UC or Crohn’s colitis with mild active inflammation or Post-inflammatory polyps or Family history CRC in first degree relative > 50	Extensive UC or Crohn’s with moderate or severe active inflammation or PSC or Any dysplasia in last 5 yr or Colonic stricture in past 5 yr or Family history CRC in first degree relative < 50

CRC: Colorectal cancer; PSC: Primary sclerosing cholangitis; UC: Ulcerative colitis; BSG: British Society of Gastroenterology; ECCO: European Crohn’s and Colitis Organization; NICE: National Institute for Health and Care Excellence; AGA: American Gastroenterological Association; ASGE: American Society of Gastrointestinal Endoscopy.