Inflammatory Bowel Disease-Related Colorectal Cancer: When Do We Need To Optimize Surveillance?

Aims Inflammatory bowel diseases (IBD) are a risk factor for colorectal cancer (CRC): they are responsible for approximately 2 % of the annual mortality from CRC overall and of the 10–15 % of the annual deaths in IBD patients. However, there has been a decline in this incidence over the past 30 years, thank to CRC-surveillance programs. Identify patients’ risk factors is important to optimize surveillance. In this study we aimed to evaluate the risk factors of dysplasia and describe the prevalence of IBD related endoscopically dysplasia from a cohort of patients with longstanding disease in endoscopic/histological remission followed in a tertiary referral centre of South Italy.

Methods This is a single centre prospective study including 228 consecutive longstanding IBD patients (79 Crohn’s disease-CD and 149 Ulcerative Colitis-UC) in histological/endoscopic remission, subjected to regular surveillance using high definition white light endoscopy and Dye/Virtual Chromoendoscopy, from 2016 to 2020, with targeted biopsies in suspicious areas and complete resection of lesion with EMR/ESD. Data analyzed included: disease duration, months of surveillance, smoking, alcohol, site and behavior of disease, extraintestinal diseases, number of endoscopies and surgical interventions, therapies.

Results In the overall population we recorded 22 dysplasia in UC patients and none in CD patients: 21 low grade dysplasia and 1 high grade dysplasia on rectum lesion, of which histology confirmed the completed removal. In the comparison of UC-CRC patients and UC patients without CRC, the univariate analysis identified in the duration of the disease the only significant variable (p-value ≈ 0.01). We also found a higher incidence of dysplasia in patients in conventional therapy than those in biologics (p=0,015).

Conclusions In our study population UC and a long duration of disease are two necessary conditions for the development of dysplasia. Patients under conventional therapy have a higher risk of developing dysplasia than those treated with biologics.

Citation: Panarese A, Armentano R, Coletta S et al. OP237 OP237 INFLAMMATORY BOWEL DISEASE-RELATED COLORECTAL CANCER: WHEN DO WE NEED TO OPTIMIZE SURVEILLANCE?. Endoscopy 2021; 53: S96.

Publication History

Article published online:
19 March 2021