Surveillance for dysplasia is necessary for patients with ulcerative colitis. CON: Surveillance for ulcerative colitis-associated cancer: Time to change the endoscopy and the microscopy

Expenditure of finite health-care resources on practices that have unproven or dubious efficacy needs careful reconsideration. The influence of medicolegal considerations on this aspect of patient management is a reality that needs to be addressed. While improvements in endoscopic techniques such as chromoendoscopy are encouraging, conventional histologic analysis of biopsy samples is suboptimal. One approach-perhaps idealistic-would be to direct resources toward fundamental research and development of better molecular biomarkers of increased risk of colitis-associated cancer. In the meantime, we may have to rely on increased efforts at primary prevention and common sense.