Colonic neoplasia in young patients with inflammatory bowel disease and primary sclerosing cholangitis

MH Imam, EW Thackeray, KD Lindor - Colorectal Disease, 2013 - Wiley Online Library
MH Imam, EW Thackeray, KD Lindor
Colorectal Disease, 2013Wiley Online Library
Aim Current guidelines recommend annual surveillance for colorectal cancer (CRC) in all
patients with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC).
The aim of our study was to validate the need for annual surveillance for colon neoplasia in
patients≤ 45 of age with a combined diagnosis of PSC and IBD. Method We identified
patients,≤ 45 years of age with a combined diagnosis of PSC and IBD, who were seen at
the Mayo Clinic between 1995 and 2010. We then reviewed the medical records of the …
Abstract
Aim  Current guidelines recommend annual surveillance for colorectal cancer (CRC) in all patients with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC). The aim of our study was to validate the need for annual surveillance for colon neoplasia in patients ≤ 45 of age with a combined diagnosis of PSC and IBD.
Method  We identified patients, ≤ 45 years of age with a combined diagnosis of PSC and IBD, who were seen at the Mayo Clinic between 1995 and 2010. We then reviewed the medical records of the patients who developed colonic neoplasia defined as cancer, high‐grade dysplasia (HGD) or dysplasia‐associated lesion or mass (DALM).
Results  In the population of 784 patients ≤ 45 years of age with a combined diagnosis of PSC and IBD, 10 (1.3%) of 784 developed colonic neoplasia during the follow‐up period. Seven patients had colon cancer, one had HGD and two had a DALM.
Conclusion  Colonic neoplasia is uncommon in young patients (≤ 45 years of age) with a combined diagnosis of PSC and IBD. We suggest delaying surveillance in young patients and propose that studies should be carried out to clarify the cost‐effectiveness of annual or biannual surveillance colonoscopies according to patient age.
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