Cancer and inflammatory bowel disease Both ulcerative colitis and Crohn's colitis seem to increase the risk of colorectal cancer, the risk for ulcerative colitis is about 20% in 30 years period,
the risk seems lower for Crohn's colitis. The most important factor increasing risk of cancer is
longstanding extensive and uncontrolled disease. Those that have UC with concomitant
primary sclerosing cholangitis seem to have a greater risk for colorectal cancer, the cause is unknown.
After 10 years of diagnosis, follow up for development of dysplasia should be done, This was done by endoscopy, taking biopsies every 10 cm, but this means that lesion can be missed, so this is unacceptable, the new technique is
pancolonic chromoendoscopy.
Pancolonic chromoendoscopy include
targeted biopsies of abnormal areas detected by
staining, this include
methylene blue and indigo carmine, above fig shows the procedure, A is before stain, and B is after it, showing a lesion which was biopsied and showed dysplasia.
