title: Surveillance strategies for colitis-associated cancer: state of the art and future perspectives.
abstract: Colitis-associated cancer (CAC) represents a concrete risk of morbidity and mortality in patients with long lasting inflammatory bowel diseases. Surveillance colonoscopy is a rapidly evolving research field with profound changes from the traditional approach based on scheduled controls and random biopsy protocols. Areas covered: A literature search was performed using PubMed/Embase to review the latest evidence supporting the need for surveillance colonoscopy. By focusing on the most promising recent advances in this field, we provide a state-of-the-art overview of the current gold standards for the diagnosis and management of colitis-associated dysplasia. Expert commentary: Evidence-based and emerging data have questioned the efficacy and effectiveness of both standard surveillance colonoscopy and random biopsy protocols. The latest guidelines endorse early initiation of surveillance programs, risk-profiling assessment of colonoscopy intervals and standardized use of advanced imaging modalities to detect early dysplasia. Current trends clearly reveal increased attention to direct visualization and endoscopic management of visible dysplastic lesions, even in patients with longstanding colitis. Emerging technological advances in gastrointestinal endoscopy are expected to change the endoscopic surveillance protocols in the near future.
authors.affiliation: a Gastroenterology and Digestive Endoscopy Unit , IRCCS Policlinico San Donato , San Donato Milanese , Italy.
authors.forename: Gian Eugenio
authors.initials: GE
authors.lastname: Tontini
authors.affiliation: b Department of Medicine I , University of Erlangen-Nuremberg , Erlangen , Germany.
authors.forename: Timo
authors.initials: T
authors.lastname: Rath
authors.affiliation: a Gastroenterology and Digestive Endoscopy Unit , IRCCS Policlinico San Donato , San Donato Milanese , Italy.|c Department of Biomedical Sciences for Health , University of Milan , Milano , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pastorelli
authors.affiliation: a Gastroenterology and Digestive Endoscopy Unit , IRCCS Policlinico San Donato , San Donato Milanese , Italy.|c Department of Biomedical Sciences for Health , University of Milan , Milano , Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Vecchi
authors.affiliation: b Department of Medicine I , University of Erlangen-Nuremberg , Erlangen , Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Neumann
mesh_terms: D001706:Biopsy; D003092:Colitis / Q000150:complications* / Q000175:diagnosis; D003106:Colon / Q000473:pathology*; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003113:Colonoscopy / Q000592:standards; D055088:Early Detection of Cancer / Q000379:methods* / Q000592:standards; D006801:Humans; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: Inflammatory bowel diseases; advanced endoscopic imaging; colitis-associated cancer; colitis-associated dysplasia; colorectal cancer; surveillance colonoscopy