| Theme |
Precancerous Conditions and Cancer High-risk Lesions in the Colorectum |
| Title |
Surveillance of High Risk Colorectal Cancer Populations |
| Author |
Keiji Matsuda |
Department of Surgery, Teikyo University School of Medicine |
| Author |
Toshiaki Watanabe |
Department of Surgery, Teikyo University School of Medicine |
| [ Summary ] |
Ulcerative colitis (UC) is a high risk colorectal cancer population. The duration and extent of UC are the primary risk factors for this condition. Crohn's disease (CD) is equal to UC in terms of risk of occurrence of colorectal cancer when CD inflammation is located in the colon. The extent of inflammation associated with CD is same as that associated with UC. The presence of dysplasia is related to high risk cancer groups as is the presence of pre-cancerous lesions. There are two primary colonoscopic surveillance methods, the step biopsy adopted in the US and Europe and target biopsy, performed in Japan. The dye method and magnifying colonoscopy are becoming widely used. A finding of high grade dysplasia indicates a recommendation for total colectomy. Some controversy exists concerning the management of low grade dysplasia in flat mucosa, as to the necessity for colectomies or repeated exams. |