TITLE

COLONOSCOPIC APPEARANCES HELP PREDICT DYSPLASIA RISK IN ULCERATIVE COLITIS

AUTHOR(S)
Rutter, M.D; Schofield, G.; Wilkinson, K.H.; Forbes, A.; Saunders, B.P.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA4
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background and aim: Colonoscopic surveillance attempts to reduce the excess cancer risk in ulcerative colitis (UC). We aimed to assess whether colonoscopic appearances help to predict cancer risk. Methods: A case control study of patients on UC surveillance; 68 patients with dysplasia/colorectal cancer (CRC) and 136 patients without dysplasia/CRC were matched for age at onset of UC, duration, and extent of UC and sex. Medical and colonoscopic reports were reviewed, and data on colonoscopic appearances documented. Results: 204 patients underwent 1217 colonoscopies. Patients who had one or more macroscopically normal surveillance colonoscopies were at reduced risk of dysplasia/CRC (p = 0.004, OR 0.4 [0.2-0.7]). Patients with one or more segments of severe inflammation at any of their surveillance colonoscopies were at increased risk of dysplasia/CRC (p < 0.001, OR 4.9 [2.0-12.2]). Other results are shown in the table. Conclusion: Colonoscopic features can help predict cancer risk in UC. Severe inflammation, strictures, a shortened colon, and postinflammatory polyps appear to confer significant increased dysplasia risk, whereas a macroscopically normal colonoscopy confers a reduced (although not zero) risk of subsequent dysplasia development. Contrary to a recent report, we did not find that patients with backwash ileitis were at greater risk of developing colorectal.
ACCESSION #
9747267

 

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