Colorectal cancer surveillance in inflammatory bowel disease: A critical analysis

Table 2 Guidelines of various societies on surveillance for colorectal cancer in ulcerative colitis

Society	Year	Beginning of surveillance	Frequency	Technique	Biopsy protocol	Risk	Change
BSG	2002	All patients have colonoscopy screening at 8-10 yr; surveillance begins 8-10 yr after onset for pancolitis, 15-20 yr for left-sided colitis	Decrease in surveillance interval with increase in disease duration for pancolitis:Every 3 yr: 2nd decadeEvery 2 yr: 3rd decadeEvery 1 yr: 4th decade	Nil	2-4 random biopsies every 10 cm from the entire colon	Patients with PSC, including those with OLT, should have annual screening
AGA	2004	8-10 yr	Every 1-2 yr	Nil
ACG	2004	8-10 yr	Every 1-2 yr	Nil
ECCO	2008	8 yr for pancolitis, 15 yr for left-sided colitis	Every 2 yr: 1st two decadesEvery 1 yr: 3rd decade	CE
BSG	2010	10 yr	Based on extent of disease, endoscopic and histologic activity, FH of CRC, presence of PSC, pseudopolyps, stricture, dysplasia on biopsy:Every 3 yr: low riskEvery 2 yr: intermediate riskEvery 1 yr: high risk	CE	Random biopsies every 10 cm and biopsies from raised/suspicious areas on CE	Patients with PSC, including those with OLT, should have annual screening	If dysplastic polyp within area of inflammation can be removed entirely, colectomy is not necessary
AGA	2010	8-10 yr	Every 1-2 yrIf two examinations are negative, then every 1-3 yr up to 20 yr, then every 1-2/yr	CE		Patients with PSC, including those with OLT, should have annual screening
NICE	2011	10 yr	As per BSG 2010 guidelines	CE
Australian	2011	8-10 yr	As per BSG 2010 guidelines	CE
ECCO	2013	6-8 yr, 8-10 yr	Same as BSG	CE

ACG: Association of Coloproctology for Great Britain and Ireland; AGA: American Gastroenterological Association; BSG: British Society of Gastroenterology; CE: Chromoendoscopy; CRC: Colorectal cancer; ECCO: European Crohn’s and Colitis Organization; FH: Family history; NICE: National Institute for Health and Clinical Excellence; OLT: Orthotopic liver transplantation; PSC: Primary sclerosing cholangitis.