| Theme |
Recent advance in diagnosis and management of colorectal tumors associated with inflammatory bowel disease |
| Title |
The optimum surveillance colonoscopy for colitis-associated cancer |
| Author |
Keisuke Hata |
Department of Surgical Oncology, The University of Tokyo |
| Author |
Takahide Shinagawa |
Department of Surgical Oncology, The University of Tokyo |
| Author |
Toshiaki Watanabe |
Department of Surgical Oncology, The University of Tokyo |
| [ Summary ] |
Patients with long-standing ulcerative colitis are at high risk for development of cancer. Therefore, surveillance colonoscopy is recommended for such patients. However, the biopsy methods used for surveillance remain controversial. We reviewed the results of a multicenter, randomized controlled study comparing targeted vs. random biopsy methods in patients with ulcerative colitis. In the target group, samples were taken from suspected dysplastic lesions plus one random rectal biopsy. In the random group, 4 samples were taken at 10-cm intervals in addition to targeted biopsies. The number of dysplastic lesions detected per colonoscopy session was the primary endpoint in this study, and was comparable in both groups. No dysplastic lesions were detected using random biopsies without a history of current or past inflammation. Since this trial was conducted in tertiary care centers, it remains unknown whether the results can be generalized to routine clinical settings in general hospitals. |