Surveillance colonoscopy and systematic colonic biopsy in patients with ulcerative colitis of long duration appears to reduce the risk of colorectal cancer mortality. Patients with pan ulcerative colitis should undergo surveillance at one to 2 year intervals between 10 and 20 years of disease duration and annually thereafter. Biopsies should be taken from flat mucosa in all 4 colonic quadrants every 10 cm. Pseudopolyps need not be biopsied, but irregular mass legions and typical appearing adenomas should be biopsied or removed and the flat mucosa around them should be sampled separately. Sporadic tubular adenomas in older patients and adenomas proximal to the colitis do not mandate colectomy. High- or low-grade dysplasia in flat mucosa verified by an expert pathologist and dysplasia associated lesion or mass (DALM) are indications for colectomy. Patients should understand that surveillance colonoscopy in ulcerative colitis is not fully protective in preventing colorectal cancer mortality.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging