Surveillance des néoplasies colorectales dans les maladies inflammatoires de l’intestin
Mises à jour et approches
Résumé
L’une des plus grandes difficultés auxquelles sont confrontés les gastro-entérologues qui prennent en charge les personnes atteintes de maladies inflammatoires de l’intestin (MII) est la surveillance clinique efficace et rentable des néoplasies colorectales dans cette population. Bien que le risque accru de cancer colorectal (CCR) chez les personnes atteintes de MII soit établi depuis longtemps, ce risque a diminué au fil du temps et, selon des rapports récents, il ne semble pas supérieur à 1,5 ou 2 fois par rapport aux membres de la population générale du même âge et du même sexe. Toutefois, étant donné que le taux de CCR est toujours plus élevé dans cette population, les stratégies de surveillance actuelles sont inadéquates pour certaines personnes. À l’inverse, aucune lésion néoplasique n’est décelée chez 80 à 90 % des personnes atteintes de MII lors de la surveillance coloscopique, ce qui suggère que de nombreuses personnes atteintes de MII sont inutilement exposées aux risques de la coloscopie et que les coûts excessifs sont assumés par la société.
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