The risk of CRC developing in patients with UC and Crohn's disease are related to some risk factors. Careful follow-up should be reserved for patients with long-standing disease, early onset, extensive disease, primary SC, stenosis and a family history of CRC. For patients with Crohn's disease, strong attention should be given to young patients with extensive rectal disease.

A regular endoscopic surveillance is mandatory for the second decade of the disease, with an interval of 3 years and, after the fourth decade of the disease, annually. In the presence of one of the risk factors associated with dysplasia, a prophylactic colectomy should be considered. In patients with high-grade dysplasia or with a clear cancer, a total colectomy with mesorectal excision should be performed. Oncological and functional results after restorative proctocolectomy for rectal cancer in UC are similar to those without UC.

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