Inflammation Predicts Neoplasia in Ulcerative Colitis
AMSTERDAM — New predictors will help find the one in 20 people with ulcerative colitis who will go on to develop colorectal neoplasia, according to a large retrospective cohort study.
“The problem with cancer surveillance in ulcerative colitis is the higher relative risk of developing cancer, compared with the general population, although the absolute risk remains quite small,” said Ryan Choi, MD, from St. Mark’s Hospital in London, United Kingdom.
“The vast majority of these patients never progress to cancer,” but it would be nice to be able to identify those who will, he explained.
Dr Choi presented the study findings, along with some practical guidance, here at the European Crohn’s and Colitis Organisation 2016 Congress.
“Largest and Longest Study”
Dr Choi and his colleagues evaluated 6957 colonoscopies in 987 patients enrolled in the ulcerative colitis surveillance program at St. Mark’s. All had histologically confirmed extensive ulcerative colitis and had undergone at least two surveillance colonoscopies.
Ninety-seven patients (9.8%) developed colorectal neoplasia from 2003 to 2013.
On univariate analysis, the investigators identified seven predictors of colorectal neoplasia, including mean ulcerative colitis severity score (hazard ratio [HR], 3.55) and chronicity score (HR, 1.29). On multivariate analysis, five predictors remained.