Colorectal Dysplasia and Cancer Surveillance in Ulcerative Colitis
Ulcerative colitis (UC) is a risk factor for the development of inflammation-associated dysplasia or colitis-associated neoplasia (CAN). This transformation results from chronic inflammation, which induces changes in epithelial proliferation, survival, and migration via the induction of chemokines a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Diseases |
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| Online Access: | https://www.mdpi.com/2079-9721/9/4/86 |
| _version_ | 1827673017505808384 |
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| author | Emily Reznicek Mohammad Arfeen Bo Shen Yezaz A. Ghouri |
| author_facet | Emily Reznicek Mohammad Arfeen Bo Shen Yezaz A. Ghouri |
| author_sort | Emily Reznicek |
| collection | DOAJ |
| description | Ulcerative colitis (UC) is a risk factor for the development of inflammation-associated dysplasia or colitis-associated neoplasia (CAN). This transformation results from chronic inflammation, which induces changes in epithelial proliferation, survival, and migration via the induction of chemokines and cytokines. There are notable differences in genetic mutation profiles between CAN in UC patients and sporadic colorectal cancer in the general population. Colonoscopy is the cornerstone for surveillance and management of dysplasia in these patients. There are several modalities to augment the quality of endoscopy for the better detection of dysplastic or neoplastic lesions, including the use of high-definition white-light exam and image-enhanced colonoscopy, which are described in this review. Clinical practice guidelines regarding surveillance strategies in UC have been put forth by various GI societies, and overall, there is agreement between them except for some differences, which we highlight in this article. These guidelines recommend that endoscopically detected dysplasia, if feasible, should be resected endoscopically. Advanced newer techniques, such as endoscopic mucosal resection and endoscopic submucosal dissection, have been utilized in the treatment of CAN. Surgery has traditionally been the mainstay of treating such advanced lesions, and in cases where endoscopic resection is not feasible, a proctocolectomy, followed by ileal pouch-anal anastomosis, is generally recommended. In this review we summarize the approach to surveillance for cancer and dysplasia in UC. We also highlight management strategies if dysplasia is detected. |
| first_indexed | 2024-03-10T04:18:05Z |
| format | Article |
| id | doaj.art-839fd0ed71dd4a50b60d3d014ae5ab9b |
| institution | Directory Open Access Journal |
| issn | 2079-9721 |
| language | English |
| last_indexed | 2024-03-10T04:18:05Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diseases |
| spelling | doaj.art-839fd0ed71dd4a50b60d3d014ae5ab9b2023-11-23T07:55:57ZengMDPI AGDiseases2079-97212021-11-01948610.3390/diseases9040086Colorectal Dysplasia and Cancer Surveillance in Ulcerative ColitisEmily Reznicek0Mohammad Arfeen1Bo Shen2Yezaz A. Ghouri3Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO 65212, USADepartment of Gastroenterology, Franciscan Health, Olympia Fields, IL 60461, USAInterventional IBD Center, Department of Medicine and Surgery, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, NY 10032, USADepartment of Medicine, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO 65212, USAUlcerative colitis (UC) is a risk factor for the development of inflammation-associated dysplasia or colitis-associated neoplasia (CAN). This transformation results from chronic inflammation, which induces changes in epithelial proliferation, survival, and migration via the induction of chemokines and cytokines. There are notable differences in genetic mutation profiles between CAN in UC patients and sporadic colorectal cancer in the general population. Colonoscopy is the cornerstone for surveillance and management of dysplasia in these patients. There are several modalities to augment the quality of endoscopy for the better detection of dysplastic or neoplastic lesions, including the use of high-definition white-light exam and image-enhanced colonoscopy, which are described in this review. Clinical practice guidelines regarding surveillance strategies in UC have been put forth by various GI societies, and overall, there is agreement between them except for some differences, which we highlight in this article. These guidelines recommend that endoscopically detected dysplasia, if feasible, should be resected endoscopically. Advanced newer techniques, such as endoscopic mucosal resection and endoscopic submucosal dissection, have been utilized in the treatment of CAN. Surgery has traditionally been the mainstay of treating such advanced lesions, and in cases where endoscopic resection is not feasible, a proctocolectomy, followed by ileal pouch-anal anastomosis, is generally recommended. In this review we summarize the approach to surveillance for cancer and dysplasia in UC. We also highlight management strategies if dysplasia is detected.https://www.mdpi.com/2079-9721/9/4/86inflammatory bowel diseaseulcerative colitiscancercolitis-associated neoplasiasurveillancechromoendoscopy |
| spellingShingle | Emily Reznicek Mohammad Arfeen Bo Shen Yezaz A. Ghouri Colorectal Dysplasia and Cancer Surveillance in Ulcerative Colitis Diseases inflammatory bowel disease ulcerative colitis cancer colitis-associated neoplasia surveillance chromoendoscopy |
| title | Colorectal Dysplasia and Cancer Surveillance in Ulcerative Colitis |
| title_full | Colorectal Dysplasia and Cancer Surveillance in Ulcerative Colitis |
| title_fullStr | Colorectal Dysplasia and Cancer Surveillance in Ulcerative Colitis |
| title_full_unstemmed | Colorectal Dysplasia and Cancer Surveillance in Ulcerative Colitis |
| title_short | Colorectal Dysplasia and Cancer Surveillance in Ulcerative Colitis |
| title_sort | colorectal dysplasia and cancer surveillance in ulcerative colitis |
| topic | inflammatory bowel disease ulcerative colitis cancer colitis-associated neoplasia surveillance chromoendoscopy |
| url | https://www.mdpi.com/2079-9721/9/4/86 |
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