Colonoscopic Surveillance in Inflammatory Bowel Disease

Thomas A Ullman


Curr Opin Gastroenterol. 2005;21(5):585-588. 

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Additional noteworthy literature of the recent past includes the discovery by Rutter et al.[22] that the degree of colonic inflammatory activity over time may be an independent predictor of risk for CRC in patients with ulcerative colitis under surveillance. In their 2004 case-control study, they found that mean microscopic inflammation was independently associated with the risk for colonic neoplasia in their patients under surveillance, even though the difference in average inflammation was small between patients and controls. This association has yet to be duplicated, but it raises the question whether reducing inflammation with medications might not interfere with the colitis-dysplasia-carcinoma sequence.

Such chemopreventive strategies have been investigated, albeit with conflicting results. In her case-control analysis based in the United Kingdom, Eaden et al.[23] found a substantial CRC risk reduction for patients on mesalamine-based agents. Other studies, however, have demonstrated a lack of association between mesalamine use and the development of colorectal neoplasia in ulcerative colitis.[22,24] Whether these agents carry chemopreventive properties and, if so, where in the colitis-dysplasia-carcinoma sequence they act remains unknown.


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