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How to Optimize Colon Cancer Surveillance in Inflammatory Bowel Disease Patients

Gaidos, Jill K. J. MD, FACG; Bickston, Stephen J. MD, AGAF

doi: 10.1097/MIB.0000000000000685
Clinical Review Article

Abstract: Colitis-associated colorectal neoplasia (CRN) is a well-known complication of chronic inflammation of the colon either with ulcerative colitis (UC) or colonic Crohn's disease (CD). Studies have shown that inflammatory bowel disease (IBD) patients have an overall higher risk for colorectal dysplasia and cancer compared to the general population and this risk is further increased by certain associated factors, including extent of disease, duration of disease, and age at onset. In addition, other risk factors not related to IBD can also further increase the risk for CRN, such as a family history of sporadic colon cancer and a concomitant diagnosis of primary sclerosing cholangitis. The society guidelines mostly agree on the appropriate time to begin CRN surveillance but vary somewhat on the appropriate intervals between surveillance colonoscopies. In addition, there is not yet a consensus on the appropriate method for surveillance. In this review, we discuss the risk for CRN in colonic IBD, the associated factors that further increase the risk for CRN, the current surveillance guidelines and the current methods available for CRN surveillance.

Article first published online 1 March 2016.

*Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia; and

Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, Virginia.

Reprints: Stephen J. Bickston, MD, AGAF, West Hospital, 14th Floor, 1200 E. Broad Street, PO Box 980341, Richmond, VA 23298-0341 (e-mail:

The authors have no conflict of interest to disclose.

Received September 29, 2015

Accepted October 14, 2015

© Crohn's & Colitis Foundation of America, Inc.
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