Quality of Surveillance Impacts the Colitis-Associated Advanced Neoplasia Risk: A Multicenter Case-Control Study

Groen, Maarten te; Derks, Monica E.W.; Broeder, Nathan den; Peters, Charlotte P.; Dijkstra, Gerard; Vries, Annemarie de; Römkens, Tessa E H; Horjus, Carmen S.; Boer, Nanne de; Jong, Michiel de; Nagtegaal, Irıs D.; Derikx, Lauranne; Hoentjen, Frank

doi:10.1016/j.cgh.2022.12.010

Cited by 7 publications

(5 citation statements)

References 32 publications

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“…However, large numbers of both CD-CRC and sporadic CRC cases were included, representing multiple institutions and, thus, Japanese clinical practice over the past 4 decades. Previous reports have shown that diagnosis in a later period is associated with better survival outcomes (25,35,36). In our study, diagnosis during 2009–2020 was significantly associated with better survival of RC, but not CC.…”

Section: Discussionmentioning

confidence: 99%

“…With the geographical differences, it is necessary to establish tailor-made diagnostic and therapeutic strategies. In Western countries, regular colonoscopy is recommended for CD-CRC surveillance because of increasing detection of CRC, reducing the risk of advanced cancer(25,(35)(36)(37), but is often difficult because of anorectal stenosis or anal fistulas. Computed tomography and magnetic resonance imaging are useful for determining the extent of lesions but not necessarily for early detection.…”

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confidence: 99%

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Crohn's Disease–Associated Anorectal Cancer Has a Poor Prognosis With High Local Recurrence: A Subanalysis of the Nationwide Japanese Study

et al. 2023

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on behalf of the Study Group for Inflammatory Bowel Disease Associated Intestinal Cancers by the Japanese Society for Cancer of the Colon and Rectum INTRODUCTION: Colorectal cancer (CRC) is one of the major life-threatening complications in patients with Crohn's disease (CD). Previous studies of CD-associated CRC (CD-CRC) have involved only small numbers of patients, and no large series have been reported from Asia. The aim of this study was to clarify the prognosis and clinicopathological features of CD-CRC compared with sporadic CRC. METHODS:A large nationwide database was used to identify patients with CD-CRC (n 5 233) and sporadic CRC (n 5 129,783) over a 40-year period, from 1980 to 2020. Five-year overall survival (OS), recurrence-free survival (RFS), and clinicopathological characteristics were investigated. The prognosis of CD-CRC was further evaluated in groups divided by colon cancer and anorectal cancer (RC). Multivariable Cox regression analysis was used to adjust for confounding by unbalanced covariables.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Crohn's Disease–Associated Anorectal Cancer Has a Poor Prognosis With High Local Recurrence: A Subanalysis of the Nationwide Japanese Study

et al. 2023

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“…Another limitation is that this study did not evaluate the quality parameters of endoscopy or the type of surveillance practice. Several variables including cecal intubation rates, bowel preparation, and withdrawal time are known to affect neoplasia detection and post-colonoscopy CRC [47,48]. In addition, the use of random biopsies and dye-spray or digital chromoendoscopy, especially in high-risk patients, could improve diagnostic yield.…”

Section: Discussionmentioning

confidence: 99%

Treat-to-Target and Regular Surveillance of Inflammatory Bowel Disease Are Associated with Low Incidence and Early-Stage Detection of Malignancies: A Retrospective Cohort Study

Parigi,

Allocca,

Furfaro

et al. 2023

Cancers

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Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), increase the risk of malignancies, particularly colorectal cancer (CRC). We aimed to assess the incidence of malignancies in IBD patients managed using a treat-to-target approach and recommended surveillance. We retrospectively searched the electronic databases of two tertiary IBD centers in Milan from 2010 to 2019 for new diagnoses of malignancy in patients with pre-existing IBD. A total of 5239 patients with a follow-up of 19,820 years were included. In total, 71 malignancies were diagnosed in 70 patients (38 CD, 32 UC) with a mean age of 52.9 years, of whom 64% were former or active smokers. The annual incidence of all malignancies was 358 per 100,000 patient years (95% CI 275–444), and the standardized incidence rate (SIR) was 0.93 (95% CI 0.73–1.16). Gastrointestinal cancers were the most frequent (n = 17, 23.9%), in particular, CRC (n = 9), with an incidence of 45 per 100,000 (95% CI 15–74) and an SIR of 1.18 (95% CI 0.54–2.09). CRC occurred mainly in UC patients (6/8), while small bowel cancer was seen in CD patients (5/9). Melanoma and breast cancer (n = 8 each) were the most common non-GI cancers. No significant difference in incidence was found between CD or UC. Death occurred in nine patients (11%) and was due to cancer in eight of these cases, two of which were IBD-related. Most malignancies included in the surveillance were diagnosed at early (I–II) stages (20 vs. 4, p < 0.05). In patients with IBD, treat-to-target and strict surveillance were associated with a low incidence of cancer, similar to that of the general population, and the detection of malignancies at an early stage.

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Section: Surveillance Guidelinesmentioning

confidence: 99%

“…The outcome of IBD surveillance colonoscopy is affected by the quality of the examination (45). In a Dutch case-control study, delayed surveillance intervals and active inflammation were associated with advanced neoplasia, whereas colonoscopies compliant with quality indicators such as cecal intubation and adequate bowel preparation were associated with reduced risk (45). Factors that have been proposed as markers of high-quality IBD surveillance colonoscopy include bowel preparation, mucosal disease activity, endoscopist's experience, type of endoscope, and whether or not enhanced imaging was used (46).…”

Section: Surveillance Guidelinesmentioning

confidence: 99%

Update on Endoscopic Dysplasia Surveillance in Inflammatory Bowel Disease

Coelho–Prabhu

2023

Am J Gastroenterol

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As medical management of inflammatory bowel disease (IBD) makes great advances, most patients with IBD will have long life expectancies without need for total colectomy. With prolonged disease duration, however, there is increased risk of dysplasia leading to colorectal cancer (CRC). Multiple consensus and guideline documents have been published over the last decade with recommendations to optimize early detection and management of dysplastic lesions. Endoscopic technology has improved tremendously, even over the last few years. Previously invisible dysplasia has become visible in most cases with advanced imaging technologies that now allow for much clearer and more detailed mucosal inspection. New tools to facilitate endoscopic resection of visible lesions has also enabled patients to avoid colectomy, with resulting need to continue colon surveillance. There are limited or conflicting data leading to inconsistent recommendations regarding the need for random biopsies, the preferred endoscopic imaging technique and surveillance intervals after resection of dysplasia. Similarly, there remains significant variability in the application of guidelines into daily practice and availability of and training with advanced imaging technologies. Here, we present a narrative review of which patients are at highest risk for dysplasia, the current guidelines on surveillance colonoscopy, factors affecting optimal mucosal visualization, enhanced imaging techniques, standardized reporting terminologies for surveillance colonoscopy, endoscopic management of dysplasia, indications for colectomy, and briefly on future potential technologies to assist in dysplasia detection.

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Quality of Surveillance Impacts the Colitis-Associated Advanced Neoplasia Risk: A Multicenter Case-Control Study

Cited by 7 publications

References 32 publications

Crohn's Disease–Associated Anorectal Cancer Has a Poor Prognosis With High Local Recurrence: A Subanalysis of the Nationwide Japanese Study

Crohn's Disease–Associated Anorectal Cancer Has a Poor Prognosis With High Local Recurrence: A Subanalysis of the Nationwide Japanese Study

Treat-to-Target and Regular Surveillance of Inflammatory Bowel Disease Are Associated with Low Incidence and Early-Stage Detection of Malignancies: A Retrospective Cohort Study

Update on Endoscopic Dysplasia Surveillance in Inflammatory Bowel Disease

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