- 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.
- 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.
- 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.
- Retrospective design.