Colonic IBD: 2 negative colonoscopies predict low risk for aCRN

  • Ten Hove JR & al.
  • Gut
  • 2 May 2018

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Because patients with colonic IBD are at increased risk for colorectal cancer (CRC), many patients are advised to undergo screening colonoscopies every 1-2 years.
  • A new study suggests that among patients with longstanding colonic IBD, 2 consecutive negative colonoscopies predict low risk for advanced colorectal neoplasia (aCRN), defined as high-grade dysplasia or CRC.

Why this matters

  • The authors recommend less frequent screening colonoscopies (>2 years) in low-risk patients with longstanding colonic IBD after consecutive negative colonoscopies in the absence of additional risk factors.

Study design

  • Multicenter, multinational database of 775 patients with longstanding colonic IBD (median duration, 14 years), which compared patients with consecutive negative colonoscopies to those with ≥1 positive colonoscopy.
  • A negative surveillance colonoscopy was defined as having no postinflammatory polyps, no strictures, no endoscopic disease activity, and no evidence of neoplasia.
  • A positive colonoscopy had at least 1 of these features.
  • Funding: None.

Key results

  • 44% of the 775 patients had ≥1 negative colonoscopy.
  • Follow-up was 6.1 years (25th-75th percentiles: 4.6-8.2).
  • The incidence of aCRN in those with negative consecutive colonoscopies was 0/100 patient-years vs 0.29-0.76/100 patient-years (P=.02) in those having ≥1 positive colonoscopy.

Limitations

  • Retrospective design.

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