The role of cancer surveillance in long term prognosis of ulcerative colitis.

The cancer risk in patients with extensive colitis has increased. It seems to be of a moderate degree in the long-term perspective when looking at it in epidemiological terms and studies. All methods of selecting patients for cancer prophylactic surgery have their merits and disadvantages. The decision could be made only on the duration and extent of the disease. Then there is a risk of an unnecessary surgery including post-operative mortality and morbidity. By including histological and endoscopical findings in the decision one increases the precision of selection but one runs the risk of missing carcinoma which may develop in occasional patients. Hopefully in the future additional methods will increase our means of selection as an important part of the long-term management for these patients.