Low incidence of significant dysplasia in a successful endoscopic surveillance program of ulcerative colitis patients

Rozen, Paul; Baratz, M; Fefer, Fred; Gilat, Tuvia

doi:10.1016/s0016-5107(05)80389-x

Cited by 20 publications

(24 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In many of the hitherto reported surveillance programmes, the technical feasibility of the concept has, indeed, been proven [23,25,29,30,31], and, moreover, non-randomized studies have indicated that surveyed UC patients have much less risk of dying from CRC than do non-surveyed patients [30,32].…”

Section: Colonoscopic Surveillance In Ulcerative Colitismentioning

confidence: 99%

“…It has been estimated that approximately 33 biopsies are necessary to allow 90% confidence of detecting focal dysplasia [40]. Even so, the experience from several prospective colonoscopic programmes shows that biopsies taken from six to ten different sites throughout the colon and rectum are sufficient for dysplasia to be detected, and, thereby, the risk of an incurable CRC's being missed is low [22,23,25,29,30,31,32].…”

Section: Biopsy Samplingmentioning

confidence: 99%

“…In some studies the predictive value of such findings is rather limited for future development of dysplasia of higher grades [23,31]. In a recent study [47] the authors found that dysplasia of any grade, including indefinite, probably dysplastic changes, was an indication for colectomy, due to a high probability of coexistent carcinoma.…”

Section: Indefinite Probably Positive (Probably Dysplastic) Changesmentioning

confidence: 99%

“…It appears that colonoscopic surveillance has the potential of also detecting UC-associated CRC without preceding dysplasia at an early stage, provided that the surveillance intervals are strictly adhered to [23,25,31]. A DALM with only indefinite changes should be handled with delicacy, as more-severe dysplasia, or even carcinoma, might be hidden underneath the epithelium.…”

Section: High-grade Dysplasia Dalm and Colorectal Cancermentioning

confidence: 99%

See 3 more Smart Citations

Dysplasia in ulcerative colitis?clinical consequences?

Sjöqvist

2004

Langenbecks Arch Surg

View full text Add to dashboard Cite

The safest way of handling UC patients at high risk of developing CRC is by performing regular colonoscopic surveillance. Dysplasia is a useful prognostic marker for subsequent cancer development but has its limitations. A combination of enhanced colonoscopic surveillance using markers that are more sensitive than dysplasia might be the optimal way to manage the increased CRC risk in these patients.

show abstract

Section: Colonoscopic Surveillance In Ulcerative Colitismentioning

confidence: 99%

Section: Biopsy Samplingmentioning

confidence: 99%

Section: Indefinite Probably Positive (Probably Dysplastic) Changesmentioning

confidence: 99%

Section: High-grade Dysplasia Dalm and Colorectal Cancermentioning

confidence: 99%

See 2 more Smart Citations

Dysplasia in ulcerative colitis?clinical consequences?

Sjöqvist

2004

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…Based on an estimation of hazard rates, it has been suggested that colonoscopy should be performed every 3 years for the first 12 years, then every 2 years for 6 years, then annually [76]. In patients in whom dysplasia is identified, repeat examination is often performed within 3 to 6 months [77,78]. Despite the frequency of examinations and the number of biopsies performed, surveillance colonoscopy in UC is safe, with low complication rates in large reported series [70,74,77].…”

Section: Techniquementioning

confidence: 99%

Cancer and Inflammatory Bowel Disease: Bias, Epidemiology, Surveillance, and Treatment

Solomon

Schnitzler

1998

World j. surg.

View full text Add to dashboard Cite

Individuals with chronic ulcerative colitis are at increased risk of developing colorectal carcinoma, particularly if there is long-standing disease or extensive colitis. It is generally accepted that the risk of colorectal cancer does not begin until 8 to 10 years after the time of diagnosis of ulcerative colitis. Thereafter it increases by approximately 0.5% to 1.0% per year. In patients with Crohn's disease, the risk of malignancy is smaller and less well defined. The most significant predictor of the risk of malignancy in patients with inflammatory bowel disease is the presence of dysplasia in colonic biopsies. There is considerable controversy in the literature regarding the efficacy of colonoscopic surveillance programs and the role of prophylactic surgery to prevent colorectal cancer. Surveillance certainly fails to detect carcinoma in some patients who are having regular colonoscopy. Concerns have also been raised as to the cost-benefit of colonoscopic surveillance in patients with colitis. Randomized controlled trials of surveillance programs are highly unlikely in view of the low prevalence of IBD in the population, the long period of observation required, and the probability of contamination of surveillance programs by colonoscopy for assessment of disease activity. Despite the lack of clear guidelines, surveillance colonoscopy and biopsy continues to be widely practiced. Research is proceeding to identify genetic and biochemical markers that may prove clinically useful for predicting cancer risk. At present, however, surveillance programs are likely to continue according to institutional practice. It is important for those participating in such programs to be aware of the limitations of colonoscopy and biopsy as a means of reducing the risk of cancer in inflammatory bowel disease.

show abstract

A patient with rectal cancer associated with ulcerative colitis in whom endoscopic ultrasonography was useful for diagnosis

Shimizu

Myojo

Nagashima

et al. 1999

Journal of Gastroenterology

View full text Add to dashboard Cite

Endoscopic ultrasonography (EUS) was helpful for the diagnosis of rectal cancer associated with ulcerative colitis. The patient was a 38-year-old Japanese man with a 19-year history of relapsing-remitting type ulcerative colitis involving the entire colon. Routine colonoscopy revealed multiple polypoid prominences in the upper portion of the rectum. EUS revealed a hypoechoic mass in the submucosa beneath and around the polypoid lesion on the most oral side. Signet ring cells were found in a biopsy specimen from this lesion. Subtotal colectomy was performed. A depressed lesion was observed around the prominence on the most oral side; histologically, this lesion was poorly differentiated mucinous and signet ring cell carcinoma extending into the subserosa. The polypoid lesion on the most anal side was well differentiated adenocarcinoma, which was limited to the mucosa. Our findings suggest that EUS is helpful for detecting invasive cancer associated with ulcerative colitis.

show abstract

Low incidence of significant dysplasia in a successful endoscopic surveillance program of ulcerative colitis patients

Cited by 20 publications

References 0 publications

Dysplasia in ulcerative colitis?clinical consequences?

Dysplasia in ulcerative colitis?clinical consequences?

Cancer and Inflammatory Bowel Disease: Bias, Epidemiology, Surveillance, and Treatment

A patient with rectal cancer associated with ulcerative colitis in whom endoscopic ultrasonography was useful for diagnosis

Contact Info

Product

Resources

About