de Jong D J, Nagengast F M
Universitair Medisch Centrum St Radboud, afd. Maag-, Darm- en Leverziekten, Postbus 9101, 6500 HB Nijmegen.
Ned Tijdschr Geneeskd. 2007 Dec 15;151(50):2758-60.
In patients with ulcerative colitis the risk of colorectal cancer is increased. Based on a number of studies, British and American guidelines support endoscopic surveillance in these patients. As the cancer risk in ulcerative colitis increases with disease duration, it is recommended that surveillance is started 8-20 years after diagnosis depending on the extent of disease. Although previous studies have shown that the observed cancer risk in colonic Crohn's disease is unrelated to duration of disease, similar surveillance of these patients is suggested. A substantial number of cases of carcinoma in patients with inflammatory bowel disease present before scheduled onset of surveillance. Therefore, the optimal time of onset of surveillance is disputable. However, taking into account the relatively low risk of colorectal cancer in the early stages of inflammatory bowel disease, it will be hard to achieve an acceptable risk-benefit ratio of extending surveillance by starting surveillance colonoscopies at a younger age.
溃疡性结肠炎患者患结直肠癌的风险会增加。基于多项研究，英国和美国的指南支持对这些患者进行内镜监测。由于溃疡性结肠炎的癌症风险随病程延长而增加，建议根据疾病范围在诊断后8至20年开始监测。尽管先前的研究表明，结肠克罗恩病中观察到的癌症风险与病程无关，但仍建议对这些患者进行类似的监测。相当数量的炎症性肠病患者的癌病例在预定的监测开始时间之前就已出现。因此，监测的最佳开始时间存在争议。然而，考虑到炎症性肠病早期结直肠癌的风险相对较低，通过在较年轻时开始监测结肠镜检查来延长监测时间，将很难实现可接受的风险效益比。
