Thanks guys for your detailed replies. Isn't one of the main reasons for annual pouchoscopies to take biopsies to screen for dysplasia?
Scott, I agree with you about the risk of rectal cuff cancer being small, but there should still be a clinical motivation to biopsy the cuff regardless of its present state of inflammation. I had severe UC for years, especially in the rectum, so my risk is obviously still higher than the average person's. As a result, the decision not to biopsy can really only be interpreted as a desire to limit costs and resources. Furthermore, I hadn't even had bloodwork done for two years, and they still weren't prepared to order any for me until I asked repeatedly. My doctors in the U.S. always advised bloodwork every six months. The thinking here is that tests aren't ordered unless there's a clear problem; maintenance/monitoring tests are considered unnecessary.