The cancer risk of low-grade dysplasia in chronic ulcerative colitis is variable and its management remain contentious.
Dr Thomas and colleagues team from England determined the risk of cancer or any advanced lesion once low-grade dysplasia is diagnosed.
The team conducted a MEDLINE, EMBASE and Pub Med search using the key words 'surveillance', 'colorectal cancer', 'low-grade dysplasia' and 'ulcerative colitis'.
The research team applied a random effects model of meta-analysis.
|The risk of cancer is 9-fold with low-grade dysplasia|
|Alimentary Pharmacology & Therapeutics|
The researcher identified 20 surveillance studies that had 508 flat low-grade dysplasia or low-grade dysplasia with dysplasia-associated lesion or mass.
The research team found that an average of 4 colonoscopies was performed/patient post-low-grade dysplasia diagnosis.
An average of 18 biopsies taken per colonoscopy detected 73 advanced lesions pre-operatively.
The cancer incidence was 14 of 1000 person years duration.
The researchers found that the incidence of any advanced lesion was 30 of 1000 person years duration.
When low-grade dysplasia is detected on surveillance there is a 9-fold risk of developing cancer, and 12-fold risk of developing any advanced lesion.
Dr Thomas' team concluded, “The risk of developing cancer in patients with low-grade dysplasia is high.”
“These estimates are valuable for decision-making when low-grade dysplasia is encountered on surveillance.”