How do I prevent colon cancer in UC?
The first line of colon cancer prevention is surveillance colonoscopy performed every 1-3 years beginning 10 years after the diagnosis of UC. These colonoscopies are performed by taking approximately 32 random tissue biopsies throughout the colon, in addition to samples of any abnormal appearing tissue. Dysplasia, a pre-cancerous lesion, can often be identified before it progresses into cancer. Once dysplasia is identified, options include more frequent colonoscopy or colectomy.
While no randomized trials have been performed to assess the efficacy of surveillance colonoscopy, several observational studies have been performed throughout the US and Europe. These studies suggest that there is a lower risk of cancer in patients with UC who have had at least one surveillance colonoscopy and that colonoscopy is an effective method of identifying dysplasia and cancer.
Several new colonoscopic technologies and techniques are being studied in order to improve the ability of colonoscopy to identify dysplasia and cancer.
High definition endoscopy - Scopes today offer high definition video, which increases visibility of small lesions.
Chromoendoscopy – Use of indigo-carmine dye sprayed into the colon helps to highlight abnormal colonic tissue for biopsy.
Narrow Band Imaging (NBI)– Similar to chromoendoscopy, NBI uses light filters, instead of dye, to aid identification of abnormal tissue.
Endomicroscopy- A microscope mounted on the colonoscope enables the evaluation of suspicious lesions in real time for more directed examination and biopsy.
Which, if any, of these methods will become standard of care is yet to be seen.
Next week:
Are there medications that prevent colon cancer?...Is there any way to guarantee that colon cancer will not occur?