Strategies for detecting colon cancer in patients with inflammatory bowel disease

Bye, William A.; Nguyen, Tran M; Parker, Claire E; Jairath, Vipul; East, James E.

doi:10.1002/14651858.cd000279.pub4

Cited by 55 publications

(47 citation statements)

References 74 publications

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“…Colonoscopy should be mandatory in older patients and when there is a personal and/or a family history of colorectal neoplasms or documented advanced adenoma, IBD, history of altered bowel habits, recent significant weight loss, and a laboratory findings of iron deficiency anemia or a positive fecal immunochemical test (FIT) and guaiac-based fecal occult blood test (gFOBT) [25][26][27][28][29][30].…”

Section: Patients With Hd and Rectal Bleeding Should Undergo Colonoscmentioning

confidence: 99%

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease

et al. 2020

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Hemorrhoidal disease (HD) is the most common proctological disease in the Western countries. However, its real prevalence is underestimated due to the frequent self-medication. The aim of this consensus statement is to provide evidence-based data to allow an individualized and appropriate management and treatment of HD. The strategy used to search for evidence was based on application of electronic sources such as MEDLINE, PubMed, Cochrane Review Library, CINAHL, and EMBASE. These guidelines are inclusive and not prescriptive. The recommendations were defined and graded based on the current levels of evidence and in accordance with the criteria adopted by American College of Chest Physicians. The recommendations were graded A, B, and C.

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Section: Patients With Hd and Rectal Bleeding Should Undergo Colonoscmentioning

confidence: 99%

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease

et al. 2020

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“…Chronic inflammation is thought to increase oxidative stress, induce DNA damage, alter epithelial cell surface receptor expression, and derange the cytokine milieu that ultimately results in neoplastic changes . While endoscopic surveillance for dysplasia is a key component of chronic UC management, field cancerisation effects secondary to inflammation may be more effectively attenuated by chemoprevention. Recent work suggests that it is cumulative inflammatory burden which contributes to development of CRC, thus in theory any drug preventing inflammation might mediate this risk .…”

Section: Discussionmentioning

confidence: 99%

Systematic review with meta‐analysis: high prevalence and cost of continued aminosalicylate use in patients with ulcerative colitis escalated to immunosuppressive and biological therapies

Guizzetti

Cipriano

et al. 2018

Aliment Pharmacol Ther

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Summary Background Aminosalicylates are the most frequently prescribed treatment for ulcerative colitis (UC). In the absence of empirical evidence, clinicians are uncertain whether to continue aminosalicylates in patients with UC after escalating therapy. Aims To quantify concomitant aminosalicylate use in UC randomised clinical trials (RCTs), identify factors associated with their use, and estimate treatment costs of concomitant aminosalicylate therapy. Methods MEDLINE, Embase, and CENTRAL were searched from inception to 1 March 2017 for placebo‐controlled RCTs of immunosuppressants, biologics, or oral small molecules in adults with UC. The proportion of patients prescribed concomitant aminosalicylates at trial entry was pooled using a random‐effects model. Meta‐regression was performed to assess trial‐level factors associated with aminosalicylate use. Treatment costs were estimated using 2018 formulary data from five Canadian provinces. Results Thirty‐two trials were included (23 induction only, nine induction, and maintenance trials). The pooled proportion of patients co‐prescribed aminosalicylates was 80.7% (95% CI 75.5%‐85.1%), with considerable observed heterogeneity (I2 = 95%). In univariable meta‐regression, aminosalicylate use was not associated with trial design, setting, year of publication, disease severity, disease duration, or drug class. The estimated direct annual treatment cost of concomitant aminosalicylates is ~$20 million for the Canadian UC population, assuming conservative estimates of UC prevalence, aminosalicylate use and dose, and the lowest cost formulation. Conclusions Approximately 80% of UC patients entering clinical trials of immunosuppressants, biologics, or oral small molecules continue to use aminosalicylates. An RCT is needed to inform the benefits and harms of continuing vs stopping aminosalicylates in patients escalating therapy.

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“…Recent publications suggest that the risk may be less than originally estimated between 1.1% and 5.3% at 20 years exposure . A variety of reasons have been considered for the discrepancy and it is unclear whether it reflects the methodological limitations of these studies, effect of surveillance and treatment on disease process or effects of other factors on actual risk …”

Section: Introductionmentioning

confidence: 94%

“…Certain risk factors confer an increased risk including longer duration of disease, greater extent of disease, family history of CRC, concomitant primary sclerosing cholangitis and younger age at diagnosis . Screening and surveillance is performed to identify dysplasia and malignancy early in order to improve survival and outcomes, although there is only low‐grade evidence to support that at this stage …”

Section: Introductionmentioning

confidence: 99%

Long‐term incidence of dysplasia and colorectal cancer in an ulcerative colitis population‐based cohort

Tranter‐Entwistle

Mullaney

Noah

et al. 2020

ANZ Journal of Surgery

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Background: Ulcerative colitis (UC) is a risk factor in developing colorectal cancer (CRC). Surveillance programmes aim to identify premalignant lesions to facilitate improved treatment outcomes. Recent studies have suggested that the risk of CRC in UC has decreased. This study aims to characterize the risk of CRC in UC in a population-based New Zealand cohort. Methods: All patients in the Canterbury Inflammatory Bowel Disease Study, a comprehensive population-based cohort, were reviewed and cases of dysplasia and CRC identified. Demographic data and risk factors were assessed and standardized incidence ratios (SIRs) calculated comparing with the national population. Results: A total of 518 UC cases were analysed (46.3% female). Median follow-up was 17.5 years (interquartile range 12.2-25.1 years). Neoplasia developed in 42 (8.1%) patients, 14 (2.7%) of whom had CRC. The mean age at CRC diagnosis was 63.3 years, and mean duration with UC before CRC 18.4 years (0-36.8 years). The total incidence rate was 1.35/1000 person-year duration (95% confidence interval 0.74-2.27). The age-adjusted SIR was 1.74 (95% confidence interval 1.03-2.93) compared to the New Zealand population. Risk factors for any dysplasia included disease extent and male gender. Conclusion: In this population-based cohort with long-term follow-up, the SIR of CRC in UC patients was significantly lower than the initial epidemiological studies although similar to more recent studies. This increased risk still justifies ongoing screening in the UC population.© 2020 Royal Australasian College of Surgeons ANZ J Surg 90 (2020) 821-825ANZJSurg.com

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Strategies for detecting colon cancer in patients with inflammatory bowel disease

Abstract: Strategies for detecting colon cancer in patients with inflammatory bowel disease.

Cited by 55 publications

References 74 publications

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease

Systematic review with meta‐analysis: high prevalence and cost of continued aminosalicylate use in patients with ulcerative colitis escalated to immunosuppressive and biological therapies

Long‐term incidence of dysplasia and colorectal cancer in an ulcerative colitis population‐based cohort

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