title: Adenomas in patients with inflammatory bowel disease are associated with an increased risk of advanced neoplasia.
abstract: 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.
authors: Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Fiona D M
authors: FD
authors: van Schaik
authors: Erik
authors: E
authors: Mooiweer
authors: Mike
authors: M
authors: van der Have
authors: Tim D G
authors: TD
authors: Belderbos
authors: Fiebo J W
authors: FJ
authors: Ten Kate
authors: G Johan A
authors: GJ
authors: Offerhaus
authors: Marguerite E I
authors: ME
authors: Schipper
authors: Gerard
authors: G
authors: Dijkstra
authors: Marieke
authors: M
authors: Pierik
authors: Pieter C F
authors: PC
authors: Stokkers
authors: Cyriel
authors: C
authors: Ponsioen
authors: Dirk J
authors: DJ
authors: de Jong
authors: Daniel W
authors: DW
authors: Hommes
authors: Ad A
authors: AA
authors: van Bodegraven
authors: Peter D
authors: PD
authors: Siersema
authors: Martijn G H
authors: MG
authors: van Oijen
authors: Bas
authors: B
authors: Oldenburg
mesh_terms: D000236:Adenoma / Q000473:pathology*; D000328:Adult; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000473:pathology*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011230:Precancerous Conditions / Q000473:pathology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk