Surveillance colonoscopy |
Colonoscopy with systematic biopsies |
Perform surveillance every 1 to 2 yr |
After 8 to 10 yr of disease in those with pancolitis |
After 15 yr of disease in those with left-sided colitis |
Biopsy protocol |
Biopsies every 10 cm in all 4 quadrants. |
Additional biopsies of strictures and mass lesions other than pseudopolyps |
Polyps that appear potentially dysplastic remove by polypectomy with biopsy of adjacent flat mucosa |
Dysplasia |
If HGD or multifocal low-grade dysplasia is found in flat mucosa refer for colectomy |
Presence of low-grade dysplasia, particularly if it is unifocal: no consensus |
DALM is an indication for colectomy |
Other factors of consideration to advise on colectomy |
Ongoing colitis-related symptoms |
Life expectancy |
Duration, severity and extent of colitis |
A personal history of primary sclerosing cholangitis |
A family history of colorectal cancer |
Discussion around the time of surveillance of benefit, harms, and short comings of colonoscopy surveillance |