Endoscopic surveillance for colitis-associated colorectal neoplasia (CRN) and colorectal cancer (CRC) is recommended by multiple national and international gastrointestinal (GI) societies.1, 2, 3, 4, 5, 6, 7 and 8 The goal of endoscopic surveillance is to reduce the morbidity and mortality of CRC, by either GW-572016 detecting and resecting dysplasia or detecting CRC at earlier, potentially curable stages.9 Randomized controlled trials (RCTs) assessing the efficacy of surveillance colonoscopy in IBD have not been performed, and likely will

not be performed.6 Case series, case-control studies, and population-based cohort studies suggest that use of surveillance colonoscopy is associated with an earlier stage of cancer diagnosis and improved CRC-related survival in IBD patients.10, 11, 12, 13 and 14 Although a Cochrane analysis from 2006 concluded that there is no clear evidence that surveillance colonoscopy prolongs survival

in patients with extensive colitis,15 a subsequent cohort study of 149 patients with IBD-associated CRC from the Netherlands, not included in selleck products the Cochrane analysis, found a 100% 5-year survival of 23 patients enrolled in a surveillance program before CRC detection, compared with 74% in a nonsurveillance group (P = .042). 14 Of 30 CRC-related deaths during the study period (January 1, 1990 to July 1, 2006), only 1 patient was in the surveillance group compared with 29 in the nonsurveillance group (P = .047). It was also noted that 52% of patients in the surveillance group had Stage 0 to 1 CRC, compared with 24% in the nonsurveillance group (P = .004). 14 In an exploratory cost-effectiveness model performed by the National Institute for Health and Clinical Excellence (NICE), colonoscopy surveillance

was determined to be cost-effective for high-risk groups, which included IBD patients with any history of dysplasia, extensive active colitis, primary sclerosing cholangitis (PSC), strictures within the last 5 years, or family history of CRC before 50 years of age. 6 Thus, surveillance colonoscopy in patients with ulcerative colitis (UC) and Crohn’s colitis has been 3-oxoacyl-(acyl-carrier-protein) reductase recommended by multiple societies in the United States (American Gastroenterological Society [AGA],2 American Society for Gastrointestinal Endoscopy multiple European societies (British Society for Gastroenterology [BSG],1 NICE,6 European Crohn’s and Colitis Organization [ECCO]7), the [ASGE],5 American College of Gastroenterology [ACG],4 Crohn’s and Colitis Foundation of America [CCFA],3 multiple European societies [British Society for Gastroenterology (BSG),1 NICE,6 European Crohn’s and Colitis Organization (ECCO)],7 the Cancer Council of Australia [CCA],8 the New Zealand Guidelines Group,16 and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition [NASPGHN]).