date: “2024-01-01” title: Cancer screening of inflammatory bowel disease alias: ca-IBD
Cancer screening of inflammatory bowel disease
(NEJM 2015;372:1441)
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Colon cancer: risk in UC ~2% at ↣ 10 y, ~8% at ↣ 20 y, ~18% at ↣ 30 y. Similar for pancolonic CD, plus risk of small bowel cancer as well. Dysplasia best marker for risk.
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Other risk factors include: PSC, ⊕ FHx, greater extent of disease, stricture, & pseudopolyps.
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Surveillance: colonoscopy w/ random bx 8 y after dx to eval for dysplasia, q1-3y thereafter based on risk factors. Chromoendoscopy using dye to stain high-risk lesions for targeted bx may be preferable. If high-grade dysplasia or dysplasia-assoc. lesion/mass → colectomy.
from IBD