title: Detection of Anorectal Cancer among Patients with Crohn's Disease Undergoing Surveillance with Various Biopsy Methods.
abstract: OBJECTIVE
  Crohn's disease (CD) is an inflammatory bowel disease. The risk of colorectal cancer (CRC) is increased in patients with CD. In Japan, anorectal cancer accounted for >60% of CRCs associated with CD. These anorectal cancers are typically diagnosed in advanced stages, because a surveillance protocol remains to be established. This study aimed to assess various biopsy methods for detecting CRC.
  
  
  METHODS
  This study included 72 patients (113 examinations) with CD who underwent cancer surveillance between August 2008 and October 2015. Surveillances were performed with a core needle biopsy in perianal regions (54 cases), endoscopic biopsy (90 cases), and excisional biopsy (34 cases). When it was difficult to perform colonoscopy in an outpatient setting, due to perianal pain or stricture, we employed examinations under anesthesia for surveillance.
  
  
  RESULTS
  The total CRC detection rate was 6.19% (7 examinations). CRC detection rates were 1.85% (1 case) with core needle biopsy, 5.56% (5 cases) with endoscopic biopsy, and 5.88% (2 cases) with excisional biopsy.
  
  
  CONCLUSIONS
  We showed that it was important to employ various biopsy methods in cancer surveillance to detect CRC among patients with CD.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuno
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Mizushima
authors.forename: Riichiro
authors.initials: R
authors.lastname: Nezu
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Nakajima
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Naotsugu
authors.initials: N
authors.lastname: Haraguchi
authors.forename: Junichi
authors.initials: J
authors.lastname: Nishimura
authors.forename: Taishi
authors.initials: T
authors.lastname: Hata
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000473:pathology*; D001005:Anus Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D001706:Biopsy / Q000379:methods; D003113:Colonoscopy / Q000379:methods; D003424:Crohn Disease / Q000150:complications*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D012007:Rectum / Q000473:pathology*; D012307:Risk Factors