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News

Colonic neoplasia in young patients with IBD and primary sclerosing cholangitis

This month's issue of Colorectal Disease investigates colonic neoplasia in young patients with inflammatory bowel disease and primary sclerosing cholangitis.

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Current guidelines recommend annual surveillance for colorectal cancer in all patients with inflammatory bowel disease and primary sclerosing cholangitis.

Dr Imam and colleagues validated the need for annual surveillance for colon neoplasia in patients 45 of age or less with a combined diagnosis of primary sclerosing cholangitis and  inflammatory bowel disease.

The team evaluated patients with a combined diagnosis of primary sclerosing cholangitis and inflammatory bowel disease, who were seen at the Mayo Clinic between 1995 and 2010.

The team reviewed the medical records of the patients who developed colonic

7 patients had colon cancer
Colorectal Disease

Neoplasia was defined as cancer, high-grade dysplasia or dysplasia-associated lesion or mass.

In the population of 784 patients 45 years of age with a combined diagnosis of primary sclerosing cholangitis and inflammatory bowel disease, 10 of 784 developed colonic neoplasia during the follow-up period.

The research team noted that 7 patients had colon cancer, 1 had high-grade dysplasia, and 2 had a dysplasia-associated lesion or mass.

Dr Imam concluded, "Colonic neoplasia is uncommon in young patients with a combined diagnosis of primary sclerosing cholangitis and  inflammatory bowel disease."

"We suggest delaying surveillance in young patients and propose that studies should be carried out to clarify the cost-effectiveness of annual or biannual surveillance colonoscopies according to patient age."

Colorectal Dis 2013  15(2): 198-203
25 February 2013

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