The risk, fate, and ideal management of colorectal dysplasia in inflammatory bowel disease (IBD) remain debated.
Dr Tine Jess and colleagues from Minnesota estimated the incidence, long-term outcome of colorectal dysplasia in IBD.
The team also assessed the risk factors for progression of colorectal dysplasia.
The research team evaluated flat dysplasia, and dysplasia-associated lesions or masses in a population-based IBD cohort.
The team used the Rochester Epidemiology Project to identify a cohort patients with colorectal dysplasia.
Medical records were reviewed for demographic and clinical characteristics.
Histology slides were reviewed by a pathologist blinded to previous pathology reports.
|22% of patients with adenoma-associated lesions in IBD areas developed flat low-grade dysplasia|
|Inflammatory Bowel Diseases|
The team estimated the cumulative incidence of dysplasia and the association between patient characteristics.
Recurrence or progression of dysplasia was assessed using proportional hazards regression.
The researchers found that of 29 IBD patients, 8 developed flat dysplasia.
The team noted that 1 had dysplasia-associated lesions or masses, 18 had adenoma-associated lesions or masses in areas of IBD.
Adenoma-associated lesions or masses outside areas of IBD were found in 2 patients.
Among 6 patients with flat low-grade dysplasia who did not undergo colectomy, none progressed during a median of 18 years of observation with 3 colonoscopies.
The team observed that 4 patients with adenoma-associated lesions or masses in areas of IBD with no surgery developed low-grade dysplasia or masses.
Primary sclerosing cholangitis and dysplasia located proximal to the splenic flexure were associated with risk for recurrence or progression of dysplasia.
Dr Jess' team concluded, “This population-based cohort study did not confirm an increased risk of cancer related to flat low-grade dysplasia.”
“However, 22% of patients with adenoma-associated lesions or masses in areas of IBD developed flat low-grade dysplasia or dysplasia-associated lesions or masses.”