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Central concern is progression from chronic inflammation to cancer, with patients showing about a 2.4-fold increased colorectal cancer risk versus the general population. Surgery was historically preferred, but current care is more individualized due to advances such as high-definition colonoscopy, chromoendoscopy, and refined endoscopic resection. This review summarizes risk factors, surveillance, and dysplasia classification.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-evolution-of-the-management-of-dysplasia-in-ulcerative-colitis/352737/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-evolution-of-the-management-of-dysplasia-in-ulcerative-colitis/352737.png","ImageObject",300,407,{"name":92,"@type":93},"Riley West","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",16,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is dysplasia management in ulcerative colitis considered high risk?","Question",{"text":113,"@type":114},"Ulcerative colitis-related chronic inflammation can progress to cancer. 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Vickers 1,* and Alessandro Fichera 2, *  \nAcademic Editors: Éric Chastre and Takayuki Ogino  \nReceived: 9 January 2026  \nRevised: 28 March 2026  \nAccepted: 1 April 2026  \nPublished: 4 April 2026  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Surgery, Weill Cornell Medicine, NewYork-Presbyterian, 1300 York Avenue, New York, NY 10065, USA  \n2 Section of Colon and Rectal Surgery, Department of Surgery, Weill Cornell Medicine, NewYork-Presbyterian, 1300 York Avenue, New York, NY 10065, USA  \n* Correspondence: [gch9006@med.cornell.edu](gch9006@med.cornell.edu) (A.L.V.); [sat9211@med.cornell.edu](sat9211@med.cornell.edu) (A.F.)  \nSimple Summary  \nWith modern medicine and a better understanding of the ulcerative colitis disease process, there have been many changes in how we manage ulcerative colitis-related dysplasia over the past 20 years. Patients with ulcerative colitis have about a 2.4-fold increased risk of developing colorectal cancer compared to the general population, which is concerning since colorectal cancer is the 2nd leading cause of cancer-related deaths in the United States. Colonoscopy surveillance is the main means of identifying this progression, while the classification and management of dysplasia continue to change. The aim of this review is to summarize the risk factors, surveillance methods, classification, and current management guidelines for ulcerative colitis-related dysplasia.  \nAbstract  \nWith modern medicine and a better understanding of the ulcerative colitis disease process, there have been many changes in how we manage ulcerative colitis-related dysplasia over the past 20 years. One of the biggest concerns for these patients, given the inflammatory nature of their disease, is the progression from chronic inflammation to cancer. Patients with ulcerative colitis have about a 2.4-fold increased risk of developing colorectal cancer compared to the general population, which is concerning since colorectal cancer is the 2nd leading cause of cancer-related deaths in the United States. Traditionally, surgery was the preferred treatment for ulcerative colitis patients with dysplasia, but now, with advances in surveillance such as high-definition colonoscopy and chromoendoscopy, the management approach is more nuanced. Understanding the risk for different individuals within this patient population is key to comprehensive and personalized care management. In this review article, we will explore risk factors, surveillance methods, and classification.  \nKeywords: dysplasia; ulcerative colitis; colorectal cancer  \n1. Introduction  \nUlcerative colitis is a chronic inflammatory disorder with relapsing and remitting mucosal inflammation and an increased risk of colorectal neoplasia. Twenty years ago, after a 45-year-old female with a history of left-sided ulcerative colitis (UC) was found to have unifocal visible dysplasia, she underwent a total proctocolectomy. At that time, surgical intervention was widely recommended due to concerns about synchronous neoplasia and the limitations of endoscopic detection techniques. However, with improvements in medical  \ncare, endoscopic imaging, and resection techniques, this patient can now be managed with endoscopic resection and followed with close surveillance. This clinical scenario highlights the evolution in the management of colitis-associated dysplasia and reflects a shift toward more individualized, risk-adapted care.  \nColorectal cancer remains the most feared long-term complication of ulcerative colitis and is a significant contributor to morbidity and mortality in the US. It is the second most common cause of cancer-related deaths in the US and the third most diagnosed cancer [1,2] . Patients with long-stan","cbCaiqwZ2NjTHnGJ","https://ap.wps.com/l/cbCaiqwZ2NjTHnGJ","pdf",5224840,25,"English","# Introduction\n## Evolution in dysplasia management\n## Colorectal cancer risk in ulcerative colitis","[{\"question\":\"Why is dysplasia management in ulcerative colitis considered high risk?\",\"answer\":\"Ulcerative colitis-related chronic inflammation can progress to cancer. Patients have an estimated 2.4-fold increased risk of developing colorectal cancer compared with the general population.\"},{\"question\":\"How have surveillance methods changed dysplasia care over time?\",\"answer\":\"Advances such as high-definition colonoscopy and chromoendoscopy have improved detection and characterization of dysplasia, making current management more nuanced than surgery alone.\"},{\"question\":\"What factors does the review aim to cover?\",\"answer\":\"The review focuses on dysplasia risk factors, surveillance methods, dysplasia classification, and current management guidelines for ulcerative colitis-related dysplasia.\"}]","The Evolution of the Management of Dysplasia in Ulcerative Colitis | PDF",1790101161,63]