Patients with long-standing extensive ulcerative colitis have an increased risk of colorectal carcinoma.
In this study, physicians from England assessed the proportion of dysplasia that was detected macroscopically in patients who underwent colonoscopy surveillance.
The team conducted a retrospective review of patients with ulcerative colitis who underwent surveillance between 1988 and 2002.
They used an established surveillance protocol that included random segmental biopsies every 10 cm throughout the length of the colon plus targeted biopsies of macroscopic lesions.
Neoplasia detection was categorized as resulting from either targeted or non-targeted biopsies.
Throughout the study, a total of 525 patients underwent 2204 surveillance colonoscopies.
The team found that 110 neoplastic areas were detected in 56 patients. Of these, 77% were macroscopically visible at colonoscopy.
Furthermore, they found that 50 patients had macroscopically detectable neoplasia, while 6 had macroscopically invisible lesions.
Dr Matthew Rutter and colleagues concluded, "Most dysplastic lesions in ulcerative colitis are visible at colonoscopy".
"From a clinical perspective, the endoscopic resectability of a lesion is more important than whether it is thought to be a sporadic adenoma or a dysplasia-associated lesion/mass."