Endoscopic diagnosis of colitis-associated carcinoma [Endoskopische Diagnostik des Kolitisassoziierten Karzinoms]

Ulcerative colitis is an immune disease with a chronic course, which is limited to the mucosa of the colon. Depending on the extent of the inflamed mucosa, the activity of the inflammation, the frequency of attacks, the duration of the disease and PSC as a possible accompanying disease, there is also an increased risk of colorectal cancer (so-called colitis-associated carcinoma). The inflammation activity is therefore obviously the pacemaker of carcinogenesis by ulcerative colitis. The results of meta-analyses have indicated that the total risk of developing colitis-associated carcinoma by ulcerative colitis is approximately 4%. The cumulative probabilities after disease durations of 10 years, 20 years and 30 years are approximately 2%, 8% and 18%, respectively. The inflammatory alterations normally spread continuously from the anus to the caecum, so that coloscopy is the method of choice for diagnosis and surveillance of ulcerative colitis and possible neoplasms. There is currently a dynamic development in endoscopic imaging as well as additional techniques that simplify the recognition of colitis-associated neoplasms. © 2007 Springer Medizin Verlag.