title: Review article: The relevance of surveillance endoscopy in long-lasting inflammatory bowel disease.
abstract: BACKGROUND
  Development of colitis-associated colorectal cancer is an important clinical problem in patients with colonic inflammatory bowel disease (IBD). British and American guidelines recommend to start surveillance after a disease duration of 8-10 or 15-20 years for patients with extensive or left-sided colitis, respectively.
  
  
  OBJECTIVE
  To assess the evidence level of current surveillance strategies.
  
  
  METHODS
  A PubMed-based literature search using the search terms inflammatory bowel disease, ulcerative colitis, Crohn's disease, dysplasia, colorectal cancer and surveillance was performed.
  
  
  RESULTS
  Low-grade and high-grade dysplastic lesions progress to cancer in a high percentage of patients. Furthermore, concurrent cancer is found in approximately one-third of the patients with colonic dysplasia. Low-level evidence showing reduced colorectal cancer-related mortality in patients who were undergoing surveillance is available. Patients with concomitant primary sclerosing cholangitis form a subgroup of IBD patients with an even higher risk of colorectal neoplasia.
  
  
  CONCLUSIONS
  Colonic surveillance prolongs life expectancy of patients with long-lasting IBD.
authors: Department of Gastroenterology, University Medical Center Utrecht, The Netherlands. f.vleggaar@umcutrecht.nl
authors: F P
authors: FP
authors: Vleggaar
authors: M W M D
authors: MW
authors: Lutgens
authors: M M H
authors: MM
authors: Claessen
mesh_terms: D015209:Cholangitis, Sclerosing / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D012307:Risk Factors