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  • Title: Review article: The relevance of surveillance endoscopy in long-lasting inflammatory bowel disease.
    Author: Vleggaar FP, Lutgens MW, Claessen MM.
    Journal: Aliment Pharmacol Ther; 2007 Dec; 26 Suppl 2():47-52. PubMed ID: 18081648.
    Abstract:
    BACKGROUND: Development of colitis-associated colorectal cancer is an important clinical problem in patients with colonic inflammatory bowel disease (IBD). British and American guidelines recommend to start surveillance after a disease duration of 8-10 or 15-20 years for patients with extensive or left-sided colitis, respectively. AIM: To assess the evidence level of current surveillance strategies. METHODS: A PubMed-based literature search using the search terms inflammatory bowel disease, ulcerative colitis, Crohn's disease, dysplasia, colorectal cancer and surveillance was performed. RESULTS: Low-grade and high-grade dysplastic lesions progress to cancer in a high percentage of patients. Furthermore, concurrent cancer is found in approximately one-third of the patients with colonic dysplasia. Low-level evidence showing reduced colorectal cancer-related mortality in patients who were undergoing surveillance is available. Patients with concomitant primary sclerosing cholangitis form a subgroup of IBD patients with an even higher risk of colorectal neoplasia. CONCLUSIONS: Colonic surveillance prolongs life expectancy of patients with long-lasting IBD.
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