Surveillance Colonoscopy May Reduce Colorectal Cancer Risk in Ulcerative Colitis
John Kisiel, M.D., a gastroenterologist at Mayo Clinic, helps us understand the benefits of surveillance colonoscopy for patients with ulcerative colitis (UC), which can reduce the risk of colorectal cancer. In this study, published in the American Journal of Gastroenterology, researchers report data from the St Mark’s Hospital UC surveillance program, one of the largest and longest-running programs in the world.
The study includes the following significant findings: There is a higher risk of colorectal cancer in patients with ulcerative colitis. Regular surveillance colonoscopy helps in the detection of cancer at an earlier stage, allowing patients to retain their colon for longer, as well as increasing the survival rate. Two types of colonoscopy have been performed in the last decade: chromoendoscopy, where dyes are instilled into the gastrointestinal tract, and white light colonoscopy. The rate of detection of pre-cancerous changes is significantly higher with chromoendoscopy, and it is important to note that subsequently the need for colectomy has decreased. However, the risk of interval cancer was about the same for those who got chromoendoscopy, as opposed to white light endoscopy. Thus, for patients and providers who may not have access to chromoendoscopy, high definition white light endoscopy is an effective option. Approximately 50% of patients with high grade dysplasia had a synchronous colon cancer, and routine colonoscopy and removal of the high grade lesions alone is not sufficient.
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Dr. Kisiel is a gastroenterologist at Mayo Clinic.