Utility of Random Biopsies in Patients With Inflammatory Bowel Disease

Other illness

• Any condition that the endoscopist feels is a contraindication to random biopsies
• History of visible (high or low grade) dysplasia not completely removed
• History of sessile serrated adenoma not completely removed
• History of colorectal cancer
• Any condition for which the endoscopist feels that pancolonic contrast or virtual chromoendoscopy is mandatory

Other

• Less than 2 segments of the remaining colon have ever been involved with IBD
• Colonoscopy\* in the last 11 months unless the colonoscopy:
  • was determined by the endoscopist to be insufficient for dysplasia surveillance and,
  • did not include a diagnosis of dysplasia or sessile serrated adenoma. \*Does not include sigmoidoscopy
• Inability to provide informed consent

• Diagnosis of left-sided (greater than 15 cm of disease but not beyond the splenic flexure) or extensive (extending beyond the splenic flexure) ulcerative colitis or IBD-U or colonic Crohn's disease involving at least 1/3 of the colon (defined as 2 segments of the remaining colon; segments include right colon, transverse colon, left colon and rectum).
• Disease duration must meet one of the following criteria:
  • onset of symptoms of IBD at least 8 years prior
  • diagnosis of IBD at least 8 years prior
  • diagnosis of IBD for any duration if other risk factors for colon cancer are present including: concomitant diagnosis of primary sclerosing cholangitis, personal history of dysplasia, sessile serrated adenoma or right sided hyperplastic polyps greater than 10mm in diameter, or a family history of colon cancer in a first degree relative or two second degree relatives.
• Scheduled to undergo colonoscopy as part of routine care
• At least one indication for the index colonoscopy must be to perform dysplasia surveillance.