PREMALIGNANT CHANGES IN ULCERATIVE-COLITIS

Colitis-associated carcinoma is often associated with, or preceded by, noninvasive epithelial neoplastic changes termed dysplasia. Surveilla nce colonoscopy with biopsies looking for dysplasia is now standard pr actice in the management of the cancer problem in ulcerative colitis. However, this practice continues to have a number of limitations and p roblems that need to be understood by surgeons who may be referring su ch patients. A number of recent reports indicate that colitis associat ed carcinoma is predominantly left-sided and incorporation of this dis tribution in the surveillance methods merits consideration. The molecu lar and genetic abnormalities involved in the pathogenesis of colitis associated neoplasia are being actively investigated and may yield sup plementary methods to better define individual patient risk. (C) 1995 Wiley-Liss, Inc.