Comparison of Clinical Guidelines for Ulcerative Colitis: ECCO, BSG, US and Japanese Guidelines with Reference to Surveillance Program - Abstract
Surveillance colonoscopy with random and targeted biopsies has been
recommended to detect early neoplasia in ulcerative colitis. Different national and
international gastroenterological societies, including the ECCO, BSG, AGA, ASGE and
the Japanese research group, have published similar surveillance guidelines for early
detection of dysplasia/cancer. The purpose of this study is to compare the concordance
and differences in the following sections of the guidelines, including the surveillance
colonoscopy and biopsy protocols, of these international and national guidelines for
cancer surveillance in ulcerative colitis patients. Surveillance colonoscopy and biopsy
protocol are evaluated as below: 1) Risk of CRC; 2) High risk status of cancer; 3)
Candidates for surveillance; 4) Screening colonoscopy;5) Interval of surveillance
colonoscopies; 6) Number of biopsies recommended; 7) Random or targeted
biopsies; 8) Method of random biopsy; 9) Method of targeted biopsy; 10) Use of
chromoendoscopy/magnifying colonoscopy.
Chromoendoscopy and high-resolution endoscopy may have superior ability for
the detection of neoplasia. Discussion should begin about further development of
the existing guidelines to give more effective strategies, so that patients can hope to
receive adequate surveillance in the future