Both ulcerative colitis and Crohn's colitis are associated with an increased risk of
developing colorectal cancer (CRC). Although the increased risk of CRC in colitis patients is
well established, several studies show that the risk varies widely between patients,
depending on the presence of risk factors. Recently, several of these risk factors were
implemented in the updated British guidelines for surveillance which are now used to
determine surveillance intervals in our center. The new guideline recommends stratification
of patients in a high, medium or low risk group depending on the presence of clinical and
endoscopic risk factors and to adjust the surveillance interval accordingly. Although these
guidelines provide a first step towards an individualized surveillance regimen, current data
regarding risk factors for IBD-associated CRC are solely based on retrospective studies.
Prospective data on the phenotype and genotype reliably predicting the risk of CRC is needed
to further optimize surveillance in the future.
1. To confirm established and identify new predictive factors for colorectal cancer in a
prospective cohort of IBD patients undergoing regular surveillance. Dysplasia or
colorectal cancer will be the primary outcome.
2. To provide evidence that mucosal healing results in a significant reduction of
colorectal dysplasia/neoplasia in IBD patients and that this is associated with 5-ASA or
anti-TNF maintenance therapy.
3. Study the expression of several tumor markers in biopsies, blood and faeces at baseline
and determine whether expression of these markers can predict dysplasia or colorectal
cancer development during follow-up.