Cited 19 times since 2013 (1.5 per year) source: EuropePMC Inflammatory bowel diseases, Volume 19, Issue 2, 1 1 2013, Pages 342-349 Adenomas in patients with inflammatory bowel disease are associated with an increased risk of advanced neoplasia. van Schaik FD, Mooiweer E, van der Have M, Belderbos TD, Ten Kate FJ, Offerhaus GJ, Schipper ME, Dijkstra G, Pierik M, Stokkers PC, Ponsioen C, de Jong DJ, Hommes DW, van Bodegraven AA, Siersema PD, van Oijen MG, Oldenburg B, Dutch Initiative on Crohn Colitis
Background
It is still unclear whether inflammatory bowel disease (IBD) patients with adenomas have a higher risk of developing high-grade dysplasia (HGD) or colorectal cancer (CRC) than non-IBD patients with sporadic adenomas. We compared the risk of advanced neoplasia (AN, defined as HGD or CRC) in IBD patients with adenomas to IBD patients without adenomas and patients without IBD with adenomas.
Methods
IBD patients with a histological adenoma diagnosis (IBD + adenoma), age-matched IBD patients without adenoma (IBD-nonadenoma), and adenoma patients without IBD (nonIBD + adenoma) were enrolled in this study. Medical charts were reviewed for adenoma characteristics and development of AN. The endoscopic appearance of the adenomas was characterized as typical (solitary sessile or pedunculated) or atypical (all other descriptions).
Results
A total of 110 IBD + adenoma patients, 123 IBD-nonadenoma patients, and 179 nonIBD + adenoma patients were included. Mean duration of follow-up was 88 months (SD ±41). The 5-year cumulative risks of AN were 11%, 3%, and 5% in IBD + adenoma, IBD-nonadenoma, and nonIBD + adenoma patients, respectively (P < 0.01). In IBD patients atypical adenomas were associated with a higher 5-year cumulative risk of AN compared to IBD patients with typical adenomas (18% vs. 7%, P = 0.03).
Conclusions
IBD patients with a histological diagnosis of adenoma have a higher risk of developing AN than adenoma patients without IBD and IBD patients without adenomas. The presence of atypical adenomas in particular was associated with this increased risk, although patients with typical adenomas were found to carry an additional risk as well.
