Colon Cancer, Dysplasia, and Surveillance in Patients with Ulcerative Colitis

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Abstract
Most gastroenterologists and current textbooks1 2 3 recommend that patients who have had widespread ulcerative colitis for 7 to 10 years should be entered into a surveillance program designed to detect colonic dysplasia (precancer). This involves frequent colonoscopies with multiple mucosal biopsies. The recommended frequency of colonoscopy is any time from every year to every three years. Although there is no clear rationale for choosing one interval over another, the Medical Knowledge Self-Assessment Profile, a publication of the American College of Physicians, states that patients with long-term extensive ulcerative colitis should have a colonoscopy every year.4 The argument for surveillance in such . . .