[Carcinoma in non-specific inflammatory intestinal diseases-- epidemiology, clinical aspects, dispensarization]

Idiopathic proctocolitis and Crohn's disease are important precancerous conditions in particular in patients with the onset of the disease at a young age. The causes of colorectal carcinoma in these diseases remain hypothetical. The risk must not be underrated but it is not high enough to justify prophylactic colectomy. The fundamental contribution to dispensary programmes was the discovery of dysplasia, i. e. precancerous changes of the intestinal epithelia. The main method of dispensarization is coloscopy with multiple biopsies of different segments of the colon and rectum. It is recommended to initiate dispensary programmes 10 years after the onset of the disease. Dysplasia is not an ideal marker of the increased risk of carcinoma and other indicators of malignant transformation in intestinal biopsies are intensely sought. The further development of dispensary programmes depends on these efforts and the results of cost-benefit analyses.