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Cancer and Dysplasia Surveillance

  • Gian Luigi de’Angelis
  • Federica Gaiani
  • Nicola de’Angelis
Chapter

Abstract

Colorectal cancer (CRC) and dysplasia surveillance are of paramount importance in the long-term management of inflammatory bowel disease (IBD). Chronic inflammation and immunosuppressive therapy represent risk factors. It has not yet been established which are the treatments at major risk; therefore, studies on long-term surveillance are awaited. Specific genetic mutations seem to have a role too. Although dysplastic lesions usually develop in the adult age, they must be taken into account by pediatricians. The risk to develop dysplastic lesions is mainly related to ulcerative colitis (UC), but also Crohn’s disease (CD) has to be strictly followed up.

The surveillance of cancer and dysplasia in IBD patients has to start on the identification of risk factors, including extent and duration of the disease, family history of CRC, the presence of primary sclerosing cholangitis, perianal fistulating form, and ileal CD.

Systematic endoscopic surveillance by using high definition and chromoendoscopy is strongly recommended, even though the optimal timing has not yet been clarified.

Cancer surveillance has to be considered systemically. Skin, oral, and human papillomavirus (HPV)-related cancers and hematologic disorders have to be surveilled the most.

Keywords

Inflammatory bowel disease Colorectal cancer Surveillance Endoscopy Immunosuppression 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Gian Luigi de’Angelis
    • 1
  • Federica Gaiani
    • 1
  • Nicola de’Angelis
    • 2
  1. 1.Gastroenterology and Endoscopy UnitAzienda Ospedaliero-Universitaria, University Hospital of ParmaParmaItaly
  2. 2.Department of Digestive, Hepatobiliary Surgery and Liver TransplantationHenri Mondor University Hospital, AP-HP, Université Paris Est – UPECCréteilFrance

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