How gastroenterologists screen for colonic cancer in ulcerative colitis: an analysis of performance

Eaden, Jayne; Ward, Barbara J.; Mayberry, J. F.

doi:10.1016/s0016-5107(00)70405-6

Cited by 199 publications

(124 citation statements)

References 24 publications

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“…Even the presence of LGD, which is associated with CRC in 21.4%-54%, can be considered an indication for surgery [4,6] . There is a disconcertingly low referral rate for colectomy amongst Dutch GEs, and even more so when findings are compared with 3 similar questionnaire-based studies in New Zealand, United Kingdom and Canada [12][13][14] . It is remarkable that the referral rate is higher for LGD and much lower for HGD and DALM compared with the other studies.…”

Section: Discussionmentioning

confidence: 99%

Adherence to surveillance guidelines for dysplasia and colorectal carcinoma in ulcerative and Crohn’s colitis patients in the Netherlands

Rijn

Fockens²,

Siersema³

et al. 2009

WJG

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AIM:To study adherence to the widely accepted surveillance guidelines for patients with long-standing colitis in the Netherlands. METHODS:A questionnaire was sent to all 244 gastroenterologists in the Netherlands. RESULTS:The response rate was 63%. Of all gastroenterologists, 95% performed endoscopic surveillance in ulcerative colitis (UC) patients and 65% in patients with Crohn's colitis. The American Gastroenterological Association (AGA) guidelines were followed by 27%, while 27% and 46% followed their local hospital protocol or no specific protocol, respectively. The surveillance was correctly initiated in cases of pancolitis by 53%, and in cases of left-sided colitis by 44% of the gastroenterologists. Although guidelines recommend 4 biopsies every 10 cm, less than 30 biopsies per colonoscopy were taken by 73% of the responders. Only 31%, 68% and 58% of the gastroenterologists referred patients for colectomy when low-grade dysplasia, high-grade dysplasia (HGD) or Dysplasia Associated Lesion or Mass (DALM) was present, respectively. CONCLUSION:

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Section: Discussionmentioning

confidence: 99%

Adherence to surveillance guidelines for dysplasia and colorectal carcinoma in ulcerative and Crohn’s colitis patients in the Netherlands

Rijn

Fockens²,

Siersema³

et al. 2009

WJG

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“…According to a recent survey of British gastroenterologists, only 24% conducted surveillance colonoscopy in patients with left-sided colitis, only 2% routinely took more than 20 biopsies, and only 53% recommended colectomy when high-grade dysplasia was found [8]. …”

Section: Efficacy Of Surveillance For Uc-associated Colorectal Neoplasiamentioning

confidence: 99%

Limits of Diagnosis and Molecular Markers for Early Detection of Ulcerative Colitis-Associated Colorectal Neoplasia

Fujii

Katsumata²,

Fujimori³

2008

Digestion

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The incidence of colorectal neoplasia has been increasing among patients with long-standing and extensive ulcerative colitis (UC), and therefore surveillance colonoscopy has been widely recommended. However, because UC-associated neoplasia is often difficult to detect endoscopically and to discriminate from inflammatory regenerative epithelium histologically, the efficacy of current surveillance remains unsatisfactory. In order to overcome these difficulties, adjunctive modalities for diagnosing UC-associated neoplasia, chromo- and magnifying endoscopy for endoscopic diagnosis and analysis of p53 alteration for histological diagnosis have been introduced. Furthermore, if it were possible to differentiate UC patients with long-standing and extensive colitis into subgroups with a high and a low risk of neoplasia, it would enable physicians to conduct more intensive surveillance with these modalities for patients at higher risk. Several molecular alterations of nonneoplastic epithelium in UC patients with neoplasia may be promising as markers for identifying individuals with UC at increased risk of neoplasia. We evaluated estrogen receptor (ER) methylation of nonneoplastic colorectal epithelium to clarify whether this epigenetic alteration can contribute to the prediction of increased neoplasia risk in UC patients and demonstrated that the ER methylation level in nonneoplastic epithelium was higher throughout the colorectum in patients with neoplasia than in those without. These results suggest that analysis of ER gene methylation may be potentially useful for identifying individuals at increased risk of neoplasia among patients with long-standing and extensive UC.

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“…Multiple four-quadrant biopsies of 10 cm each is the recommendation [33], but it is not frequently practiced. In the study by Eaden et al, approximately 300 British gastroenterologists were polled, but only 2% routinely performed more than 20 random biopsies [34]. Although the recommended biopsy routine only has a 0.08% yield, it is critically important in order to assess for the possibility of multifocal dysplasia, which will significantly alter surgical decision-making [35].…”

Section: Surveillance Guidelinesmentioning

confidence: 99%

The surgical treatment of inflammatory bowel disease-associated dysplasia

Connelly

Koltun²

2013

Expert Review of Gastroenterology & Hepatology

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How gastroenterologists screen for colonic cancer in ulcerative colitis: an analysis of performance

Cited by 199 publications

References 24 publications

Adherence to surveillance guidelines for dysplasia and colorectal carcinoma in ulcerative and Crohn’s colitis patients in the Netherlands

Adherence to surveillance guidelines for dysplasia and colorectal carcinoma in ulcerative and Crohn’s colitis patients in the Netherlands

Limits of Diagnosis and Molecular Markers for Early Detection of Ulcerative Colitis-Associated Colorectal Neoplasia

The surgical treatment of inflammatory bowel disease-associated dysplasia

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