Abstract
Patients with inflammatory bowel disease (IBD) are at increased risk for the development of gastrointestinal malignancies, particularly colorectal adenocarcinoma. Dysplasia, the earliest form of neoplastic colonic epithelium, is the precursor lesion to colorectal carcinoma (CRC). The identification of dysplasia before it progresses to malignancy holds promise for early intervention and potential cure, and forms the basis on which endoscopic surveillance programs have been developed for patients with IBD. While there are several important limitations to surveillance colonoscopy, there is evidence that surveillance can reduce CRC-mortality. New adjunctive techniques may allow for more effective and targeted surveillance. This article will review the natural history of dysplasia and CRC in IBD, provide an overview of the literature regarding current surveillance strategies, and outline a recommended approach to CRC-surveillance in patients with IBD.
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