Guidelines for screening and surveillance of asymptomatic colorectal cancer in patients with inflammatory bowel disease

Patients with ulcerative colitis (UC) are at increased risk of colorectal carcinoma.(1 2) Many clinicians practice colonoscopic surveillance in these patients in the hope of detecting dysplasia or an early cancer at a surgically curable stage. However, a recent audit of gastroenterologists showed such surveillance to be disorganised and inconsistent.(3) Much debate surrounds the efficacy and cost effectiveness of surveillance programmes in UC4-6 because they were introduced without benefit of randomised controlled trials.