| [ Summary ] |
Colorectal cancer is an important and life threatening complication associated with ulcerative colitis. The risk of cancer and/or dysplasia increases with the duration of the disease. Studies have shown that surveillance colonoscopy is important in order to detect malignant lesions at an early stage. However, there are some controversial issues in regard to protocols for surveillance programs. It is still unknown what the best method is to obtain biopsy specimens during colonoscopies. Step biopsies, taking four specimens every 10 cm in the large bowel, were widely performed previously. However, recent studies have shown that targeted biopsy may be more effective from the view point of cost or human resources. Another important issue is how to treat patients when low grade dysplasia is found in surveillance colonoscpic examination. Some studies recommend performing surgical resection while others recommend intense follow ups. This paper reviews controversies related to surveillance of ulcerative colitis. |