Ulcerative colitis screening

Jump to navigation Jump to search

Ulcerative colitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Ulcerative colitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Abdominal X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Alternative Treatments

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Ulcerative colitis screening On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Ulcerative colitis screening

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Ulcerative colitis screening

CDC on Ulcerative colitis screening

Ulcerative colitis screening in the news

Blogs on Ulcerative colitis screening

Directions to Hospitals Treating Ulcerative colitis

Risk calculators and risk factors for Ulcerative colitis screening

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Patients with ulcerative colitis require screening for colorectal carcinoma. The United States Preventive Task Force (USPSTF]) in patients without ulcerative colitis recommends screening for colorectal carcinoma starting at age 50 and ending at 75.[1] In case of a patient with ulcerative colitis, the risk of colorectal carcinoma is increased and so the American Cancer Society recommends having the initial screening 8 years after the patient is diagnosed with severe disease, or when most of, or the entire, large intestine is involved and 12 - 15 years after diagnosis when only the left side of the large intestine is involved.

Screening

There is a significantly increased risk of colorectal cancer in patients with ulcerative colitis after 10 years if involvement is beyond the splenic flexure. Those with only proctitis or rectosigmoiditis usually have no increased risk.[2] It is recommended that patients have screening colonoscopies with random biopsies to look for dysplasia after eight years of disease activity.[3][4]

Colorectal carcinoma

Due to the risk of colon cancer associated with ulcerative colitis, screening with colonoscopy is recommended. The American Cancer Society recommends the following schedule for colonoscopy:[5]

  • First colonoscopy 8 years after diagnosis with severe disease, or when most of, or the entire, large intestine is involved
  • First colonoscopy 12 - 15 years after diagnosis when only the left side of the large intestine is involved
  • Follow-up colonoscopy should be performed every 1 - 2 years

Have follow-up examinations every 1 - 2 years.

Post-operative surveillance

Inadequate evidence exists to recommend routine surveillance of the pouch for dysplasia or adenocarcinoma.

References

  1. "Final Update Summary: Colorectal Cancer: Screening - US Preventive Services Task Force".
  2. Ulcerative Colitis Practice Guidelines in Adults, Am. Coll. Gastroenterology, 2004. PDF
  3. Leighton JA, Shen B, Baron TH, Adler DG, Davila R, Egan JV, Faigel DO, Gan SI, Hirota WK, Lichtenstein D, Qureshi WA, Rajan E, Zuckerman MJ, VanGuilder T, Fanelli RD; Standards of Practice Committee, American Society for Gastrointestinal Endoscopy. ASGE guideline: endoscopy in the diagnosis and treatment of inflammatory bowel disease. Gastrointest Endosc 2006;63:558-65. PMID 16564852.
  4. U.S. Preventive Services Task Force (2002). "Screening for colorectal cancer: recommendation and rationale". Am Fam Physician. 66 (12): 2287–90. PMID 12507168.
  5. Kornbluth A, Sachar DB, Practice Parameters Committee of the American College of Gastroenterology (2010). "Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee". Am J Gastroenterol. 105 (3): 501–23, quiz 524. doi:10.1038/ajg.2009.727. PMID 20068560.

Template:WH Template:WS