title: Paradigm Shift in the Surveillance and Management of Dysplasia in Inflammatory Bowel Disease (West).
abstract: Patients with long-standing inflammatory bowel disease (IBD) colitis have a 2.4-fold higher risk of developing colorectal cancer (CRC) than the general population, for both ulcerative colitis (UC) and Crohn's disease (CD) colitis. Surveillance colonoscopy is recommended to detect early CRC and dysplasia. Most dysplasia discovered in patients with IBD is actually visible. Recently published SCENIC (Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus Recommendations) consensus statements provide unifying recommendations for the optimal surveillance and management of dysplasia in IBD. SCENIC followed the prescribed processes for guideline development from the Institute of Medicine (USA), including systematic reviews, full synthesis of evidence and deliberations by panelists, and incorporation of the GRADE methodology. The new surveillance paradigm involves high-quality visual inspection of the mucosa, using chromoendoscopy and high-definition colonoscopy, with endoscopic recognition of colorectal dysplasia. Lesions are described according to a new classification, which replaces the term 'dysplasia associated lesion or mass (DALM)' and its derivatives. Targeted biopsies are subsequently done on areas suspicious for dysplasia, and resections are carried out for discrete, resectable lesions.
authors: Division of Gastroenterology, Stanford University, USA.
authors: Roy
authors: R
authors: Soetikno
authors: Endoscopy Unit, VA Palo Alto, Palo Alto, USA.
authors: Tonya
authors: T
authors: Kaltenbach
authors: Department of Gastroenterology, VA San Francisco, UCSF, San Francisco, USA.
authors: Kenneth R
authors: KR
authors: McQuaid
authors: Gastroenterology Department, University of Leeds, Leeds, UK.
authors: Venkataraman
authors: V
authors: Subramanian
authors: Department of Gastroenterology, SingHealth, Singapore.
authors: Rahul
authors: R
authors: Kumar
authors: Division of Gastroenterology, The McGill University Health Centre, Montreal, Canada.
authors: Alan N
authors: AN
authors: Barkun
authors: Section of Digestive Diseases, Yale University School of Medicine, New Haven, USA.
authors: Loren
authors: L
authors: Laine
mesh_terms: D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D055088:Early Detection of Cancer; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000473:pathology* / Q000628:therapy; D011159:Population Surveillance; D017410:Practice Guidelines as Topic
keywords: chromoendoscopy; colon cancer; colonoscopy; dysplasia; inflammatory bowel disease