Colonic neoplasia in young patients with inflammatory bowel disease and primary sclerosing cholangitis.
OBJECTIVE
Current guidelines recommend annual surveillance for colorectal cancer (CRC) in all patients with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC). The aim of our study was to validate the need for annual surveillance for colon neoplasia in patients ≤45 of age with a combined diagnosis of PSC and IBD.


METHODS
We identified patients, ≤45 years of age with a combined diagnosis of PSC and IBD, who were seen at the Mayo Clinic between 1995 and 2010. We then reviewed the medical records of the patients who developed colonic neoplasia defined as cancer, high-grade dysplasia (HGD) or dysplasia-associated lesion or mass (DALM).


RESULTS
In the population of 784 patients ≤45 years of age with a combined diagnosis of PSC and IBD, 10 (1.3%) of 784 developed colonic neoplasia during the follow-up period. Seven patients had colon cancer, one had HGD and two had a DALM.


CONCLUSIONS
Colonic neoplasia is uncommon in young patients (≤45 years of age) with a combined diagnosis of PSC and IBD. We suggest delaying surveillance in young patients and propose that studies should be carried out to clarify the cost-effectiveness of annual or biannual surveillance colonoscopies according to patient age.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA. imam.mohamad@mayo.edu
M H
MH
Imam
E W
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Thackeray
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Lindor
D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D015209:Cholangitis, Sclerosing / Q000150:complications*; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D053208:Kaplan-Meier Estimate; D008297:Male; D012189:Retrospective Studies