Advances in the Diagnosis and Management of Colonic Dysplasia in Patients With Inflammatory Bowel Disease.

Authors:
Yecheskel Schneider
Yecheskel Schneider
Division of Gastroenterology and Hepatology
Stephanie Gold
Stephanie Gold
Hospital for Special Surgery
United States
Ellen Scherl
Ellen Scherl
Cornell University
United States
Adam Steinlauf
Adam Steinlauf
Mount Sinai Hospital
United States

Gastroenterol Hepatol (N Y) 2017 Jun;13(6):357-362

Dr Cohen-Mekelburg and Dr Schneider are gastroenterology fellows, Dr Gold is an internal medicine resident, Dr Scherl is a clinical professor and attending physician, and Dr Steinlauf is an assistant professor and attending physician at NewYork-Presbyterian/Weill Cornell Medical Center in New York, New York.

The prevalence of colorectal cancer (CRC) in inflammatory bowel disease (IBD) is estimated at 3.7%. Risk factors for CRC include more severe disease (as reflected by the extent of disease and the duration of poorly controlled disease), family history of CRC, pseudopolyps, primary sclerosing cholangitis, and male sex. In addition, both early and late onset of IBD have been shown to be risk factors in different studies. Most societal guidelines recommend initiation of surveillance colonoscopy at 8 to 10 years after IBD symptom onset, followed by subsequent surveillance in 1- to 2-year intervals. A recent paradigm shift has led to a focus on targeted biopsies using high-definition colonoscopy or chromoendoscopy rather than traditional white-light endoscopy, as most dysplasia has proven to be visible with these advances in technology. With this shift, endoscopic resection of focal dysplasia, rather than early recommendation for colectomy, has become commonplace. Future studies should focus on newer methods of dysplasia detection, along with comparative effectiveness trials, to determine the optimal approach. Individual risk stratification may also prove beneficial in determining optimal surveillance strategies and intervals.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5495039PMC

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June 2017
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