Dixon, A.; Wurm, P.; Robinson, R.; Hart, A.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA65
Academic Journal
Objective: The prevalence of adenomatous colorectal polyps in inflammatory bowel disease (IBD) is unknown, although recent reports suggest they might be rare in patients with ulcerative colitis (UC). Previous work has suggested 5-ASA compounds may protect against colorectal cancer. The aim of this study was to compare the prevalence of left sided adenomas in patients with IBD with a local age matched control population. Method: We reviewed the medical notes of 106 patients with histologically proven IBD, aged 55-64 years at the time of endoscopy for the presence of left sided colonic adenomas. Patients were identified through our endoscopy/histology databases. The prevalence of adenomas was compared with a healthy control population in Leicestershire aged 55-64 years who participated in a screening programme for colorectal cancer with flexible sigmoidoscopy. Results: Of 106 patients (61 male, 45 female, mean age 59 years), 80 suffered from UC, 20 from Crohn's disease and 6 from indeterminate colitis. All patients had undergone at least a flexible sigmoidoscopy and 75 had a colonoscopy. Adenomas were found in 3 patients with ulcerative colitis compared to 67 of 749 controls (2.8% v 8.9%, chi² =4.6, p=0.03). Of the 3 patients that had polyps, one patient with a 15 year history of UC had a 8mm rectal tubular adenoma, a second patient had a 4 year history of proctitis had a 2mm rectal adenoma and the third patient had, at diagnosis, a 2 cm tubulovilious odenoma. Dysplasia associated with colitis was seen in a further 4 (3.2%) patients. Pseudopolyps were found in 6 (5.6%) patients and metaplastic polyps in 2 (1.8%) patients. 75 (71%) of the IBD patients were maintained on a 5-ASA compound. Conclusions: The results suggest that adenomatous polyps are rare in patients aged 55-64 years with IBD compared to a control population. This supports the hypothesis that lesions other than polyps are important for the development of colorectal cancer in patients with LBD...


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