ENDOSCOPIC SURVEILLANCE FOR CANCER IN CHRONIC ULCERATIVE-COLITIS

  • 1 January 1980
    • journal article
    • research article
    • Vol. 73  (2) , 120-126
Abstract
Severe epithelial dysplasia in multiple colonoscopic biopsy specimens may help identify those patients with chronic ulcerating colitis (CUC) at highest risk for developing colonic cancer. This retrospective analysis of 75 patients with longstanding CUC studied by colonoscopy and biopsy disclosed 11 patients with cancer. Four of these cancers were detected by surveillance colonoscopy and 7 were detected by diagnostic colonoscopy. There was a high correlation between the presence of dysplasia and cancer in the patients. Cancer was found in 5 of 7 patients who underwent operation after colonoscopic biopsies showed severe dysplasia, none in 15 patients whose colonoscopic biopsy specimens were free of dysplasia. Dysplasia can be consistently identified. A reviewing pathologist agreed with the initial biopsy diagnosis in 59 of 64 cases (92%) and with the colectomy diagnosis in 18 of 21 (86%). Colonoscopy with multiple biopsy specimens is a valuable surveillance technique. Patients without dysplasia on biopsy should have continued surveillance.