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World J Gastrointest Endosc. Jun 16, 2017; 9(6): 255-262
Published online Jun 16, 2017. doi: 10.4253/wjge.v9.i6.255
Endoscopic recommendations for colorectal cancer screening and surveillance in patients with inflammatory bowel disease: Review of general recommendations
Jose María Huguet, Patricia Suárez, Luis Ferrer-Barceló, Lucía Ruiz, Ana Monzó, Ana Belén Durá, Javier Sempere
Jose María Huguet, Patricia Suárez, Luis Ferrer-Barceló, Lucía Ruiz, Ana Monzó, Ana Belén Durá, Javier Sempere, Digestive Disease Department, General University Hospital of Valencia, 46014 Valencia, Spain
Author contributions: Huguet JM contributed to the conception, collected materials and wrote the manuscript; Suárez P, Ferrer-Barceló L, Ruiz L, Monzó A and Durá AB collected materials and wrote the manuscript; all authors contributed to and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jose María Huguet, PhD, Digestive Diseases Department, General University Hospital of Valencia, Avenida Tres Cruces, 2, 46014 Valencia, Spain. josemahuguet@hotmail.com
Telephone: +34-60-6394982 Fax: +34-96-3131901
Received: January 28, 2017
Peer-review started: February 8, 2017
First decision: March 7, 2017
Revised: March 19, 2017
Accepted: April 18, 2017
Article in press: April 19, 2017
Published online: June 16, 2017
Abstract

Screening for colorectal cancer (CRC) in patients with inflammatory bowel disease (IBD) is recommended by all scientific societies. However, there are differences in the recommendations they make regarding screening and surveillance. We address a series of questions that come up in the daily clinical practice of a physician. The first two questions that are raised are: (1) Who should be offered screening for CRC? and (2) When should the first colonoscopy be performed? The next step is to decide who should undergo endoscopic surveillance and at what intervals they should be performed. Chromoendoscopy is emerging as the recommended endoscopic technique for screening and surveillance. The terminology for describing lesions detected with endoscopy is also changing. The management of visible lesions or non-visible dysplasia is also a motive for the review. We end the review by addressing the follow-up for endoscopically resected lesions. These questions often cannot be answered easily due to the varying degrees of evidence available; therefore, we have made some general recommendations based on those made by the various guidelines and consensuses. The first screening colonoscopy should be offered 8 years after a IBD diagnosis and we recommend that patients be stratified according to the individual risk for each for endoscopic surveillance intervals.

Keywords: Colitis surveillance, Colitis screening, Chromoendoscopy, Colorectal cancer, Inflammatory bowel disease

Core tip: There is a worldwide consensus among all scientific societies regarding the recommendation of screening for colorectal cancer in patients with inflammatory bowel disease (IBD). However, there are differences between the various recommendations that they make regarding the screening and surveillance that must be performed with these patients. We have reviewed the guidelines and consensuses from around the world on this subject and extracted some simple, general recommendations that can be used by all physicians who treat patients of this type. The first screening colonoscopy should be offered 8 years after a IBD diagnosis and we recommend that patients be stratified according to the individual risk for each for endoscopic surveillance intervals.