IBD CRC surveilance AGA 21

1. Kurdistan Board GEH/GIT Surgery J Club 2021
Supervised by Professor Dr. Mohamed Alshekhani.

2. Introduction:
 CRC has been one of the most feared complications of IBDs.
 Not long ago, notions of imperceptible CRC development & urgent need
for colectomy in the face of dysplasia dominated IBD practice.
 Improvements in disease management&endoscopic technology/quality,
have dramatically changed the way in which we conceptualize & manage
IBD-related dysplasia over the past 20 years.
 The proposed conceptual model & best practice advice statements in this
review are best used in conjunction with evolving literature& existing
societal guidelines as part of a shared decision-making process.

11. Conclusion:
 Improvements in disease management,endoscopic technology & quality,
have dramatically changed the way in which we think about IBD-related
dysplasia, aligning closely with how we conceptualize dysplasia in the non-
IBD population.
 The practices of taking nontargeted biopsies&of referring patients for
colectomy in the setting of low-grade or invisible dysplasia are being
increasingly challenged in favor of “smart” approaches by careful
inspection & targeted sampling of visible& subtle lesions using newer
technologies (including HD-WLE& DCE),endoscopic management of most
endoscopically resectable lesions ,with surgery increasingly reserved for
lesions harboring strong risk factors for invasive cancer or when
endoscopic clearance is not possible.
 More data required for the role of nontargeted biopsies when using HD
scopes, the long-term safety of endoscopic management of large/ complex
dysplastic lesions& the optimal surveillance intervals considering lifetime
inflammatory burden& other CRC risk factors.