The team assessed the efficacy of surveillance colonoscopy in patients with chronic Crohn's colitis, and reported their findings in March's Gastroenterology.
259 patients with chronic Crohn's colitis, who underwent screening and subsequent surveillance colonoscopy and biopsy since 1980, were enrolled in the study.
Biopsies were performed at 10-cm intervals and from strictures and polypoid masses. Pathology was classified as normal, dysplasia (indefinite, low-grade, high-grade), or carcinoma.
A total of 663 examinations were performed on the patients. The median interval between examinations was 24 months; examinations were performed more frequently (1-6 months) in patients with dysplasia on biopsy.
A thinner-caliber colonoscope was required to complete 12% of screening examinations and 23% of surveillance examinations.
|The screening and surveillance program detected dysplasia or cancer in 16%.
The pediatric colonoscope helped increase the researchers yield of neoplasia by 19%.
The team found that the screening and surveillance program detected dysplasia or cancer in 16% of cases.
A finding of definite dysplasia or cancer was associated with an age greater than 45 years and increased symptoms.
By life table analysis, the probability of detecting dysplasia or cancer after a negative screening colonoscopy was 22% by the fourth surveillance examination.
Dr Sonia Friedman, of the Women's Hospital, Boston, Massachusetts, concluded on behalf of the group, "Colonoscopic surveillance should be strongly considered in chronic extensive Crohn's colitis."