Editing Ulcerative colitis (section)

== '''Cancer risk/endoscopic surveillance''' ==

* 20% malignancy after 30 years of colitis - tends to arise in a field of dysplasia, which appears abnormal
* Start 8-10 years post-diagnosis - main goal is to detect dysplasia
* Limited evidence that screening actually reduces mortality
* Divide patients into three groups
** Low risk - every 5 years
** Moderate risk - every three years
** High risk (extensive or active disease, or any previous dysplasia, or other high-risk features including first-degree relatives) - every year
* Four-quadrant random biopsies every 10cm, for a total of at least 32 biopsies, in addition to suspicious lesions
* Conservative advice would be, any high-grade dysplasia on random biopsy should have total proctocolectomy
* Areas of dysplasia should have EMR. If unresectable endoscopically, should have proctocolectomy.


[[Category:Colorectal]]
[[Category:Intern education]]