Unlike the other forms of colorectal cancer screening, the screening of ulcerative colitis patients focuses on detecting dysplasia (which may be flat and identified only by random biopsies, or it may be macroscopically visible) and a subsequent prophylactic colectomy. There is no evidence of a reduction in mortality resulting from colorectal cancer screening in these patients, although annual colonoscopy screening has demonstrated a shift to early-stage detection. For patients at high risk because of known ulcerative colitis or Crohn colitis, a colonoscopy is preferred over CTC, MR imaging, or barium examinations because of its ability to obtain biopsies to look for dysplasia. Individuals with HNPCC, also known as Lynch syndrome, are at increased risk for colorectal cancer. Colorectal cancers tend to occur at a younger age and with a shorter dwell time in individuals with HNPCC [92]. Colorectal cancer screening recommendations for individuals with HNPCC or at risk (first-degree relatives) are colonoscopy every 1 to 2 years beginning at 20 to 25 years of age or earlier if familial diagnosis of colorectal cancer before age 25 years [92]. CTC Colonoscopy is preferred over CTC because of its ability to obtain biopsies to look for dysplasia. DCBE Colonoscopy is preferred over barium examinations because of its ability to obtain biopsies to look for dysplasia. Colorectal Cancer Screening MR Colonography Colonoscopy is preferred over MR imaging because of its ability to obtain biopsies to look for dysplasia. SCBE Colonoscopy is preferred over barium examinations because of its ability to obtain biopsies to look for dysplasia. DCBE Limited data have been published on the accuracy of DCBE following incomplete colonoscopy. In a study of 233 patients who underwent DCBE following incomplete colonoscopy, polyps were reported in 2.1% of patients (5 patients; 5 of 6 polyps >5 mm) [101].
Colorectal Cancer Screening. Unlike the other forms of colorectal cancer screening, the screening of ulcerative colitis patients focuses on detecting dysplasia (which may be flat and identified only by random biopsies, or it may be macroscopically visible) and a subsequent prophylactic colectomy. There is no evidence of a reduction in mortality resulting from colorectal cancer screening in these patients, although annual colonoscopy screening has demonstrated a shift to early-stage detection. For patients at high risk because of known ulcerative colitis or Crohn colitis, a colonoscopy is preferred over CTC, MR imaging, or barium examinations because of its ability to obtain biopsies to look for dysplasia. Individuals with HNPCC, also known as Lynch syndrome, are at increased risk for colorectal cancer. Colorectal cancers tend to occur at a younger age and with a shorter dwell time in individuals with HNPCC [92]. Colorectal cancer screening recommendations for individuals with HNPCC or at risk (first-degree relatives) are colonoscopy every 1 to 2 years beginning at 20 to 25 years of age or earlier if familial diagnosis of colorectal cancer before age 25 years [92]. CTC Colonoscopy is preferred over CTC because of its ability to obtain biopsies to look for dysplasia. DCBE Colonoscopy is preferred over barium examinations because of its ability to obtain biopsies to look for dysplasia. Colorectal Cancer Screening MR Colonography Colonoscopy is preferred over MR imaging because of its ability to obtain biopsies to look for dysplasia. SCBE Colonoscopy is preferred over barium examinations because of its ability to obtain biopsies to look for dysplasia. DCBE Limited data have been published on the accuracy of DCBE following incomplete colonoscopy. In a study of 233 patients who underwent DCBE following incomplete colonoscopy, polyps were reported in 2.1% of patients (5 patients; 5 of 6 polyps >5 mm) [101].