title: Detection of Dysplasia or Cancer in 3.5% of Patients With Inflammatory Bowel Disease and Colonic Strictures.
abstract: OBJECTIVE
  Colonic strictures complicate inflammatory bowel disease (IBD) and often lead to surgical resection to prevent dysplasia or cancer. We assessed the frequency of dysplasia and cancer among IBD patients undergoing resection of a colorectal stricture.
  
  
  METHODS
  We analyzed data from the Groupe d'études et thérapeutiques des affections inflammatoires du tube digestif study. This was a nationwide retrospective study of 12,013 patients with IBD in France who underwent surgery for strictures at 16 centers from August 1992 through January 2014 (293 patients for a colonic stricture, 248 patients with Crohn's disease, 51% male, median age at stricture diagnosis of 38 years). Participants had no preoperative evidence of dysplasia or cancer. We collected clinical, endoscopic, surgical, and pathology data and information on outcomes.
  
  
  RESULTS
  When patients were diagnosed with strictures, they had IBD for a median time of 8 years (3-14). The strictures were a median length of 6 cm (4-10) and caused symptoms in 70% of patients. Of patients with Crohn's disease, 3 (1%) were found to have low-grade dysplasia, 1 (0.4%) was found to have high-grade dysplasia, and 2 (0.8%) were found to have cancer. Of patients with ulcerative colitis, 1 (2%) had low-grade dysplasia, 1 (2%) had high-grade dysplasia, and 2 (5%) had cancer. All patients with dysplasia or cancer received curative surgery, except 1 who died of colorectal cancer during the follow-up period. No active disease at time of surgery was the only factor associated with dysplasia or cancer at the stricture site (odds ratio, 4.86; 95% confidence interval, 1.11-21.27; P = .036).
  
  
  CONCLUSIONS
  In a retrospective study of patients with IBD undergoing surgery for colonic strictures, 3.5% were found to have dysplasia or cancer. These findings can be used to guide management of patients with IBD and colonic strictures.
authors.affiliation: Department of Gastroenterology, Amiens University and Hospital, Université de Picardie Jules Verne, Amiens, France; Department of Gastroenterology, IBD and Nutrition Support, Beaujon Hospital, University Paris 7 Denis Diderot, Clichy, France.
authors.forename: Mathurin
authors.initials: M
authors.lastname: Fumery
authors.affiliation: Department of Gastroenterology, Huriez Hospital, Université Lille Nord de France, Lille, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Pineton de Chambrun
authors.affiliation: Department of Gastroenterology, IBD and Nutrition Support, Beaujon Hospital, University Paris 7 Denis Diderot, Clichy, France.
authors.forename: Carmen
authors.initials: C
authors.lastname: Stefanescu
authors.affiliation: Department of Hepato-Gastroenterology, University Hospital Estaing of Clermont-Ferrand, Université d'Auvergne, Clermont-Ferrand, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Buisson
authors.affiliation: Department of Pathology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: Aude
authors.initials: A
authors.lastname: Bressenot
authors.affiliation: Department of Gastroenterology, AP-HP, Hôpital Saint-Antoine F-75012, ERL 1057 Inserm/UMRS 7203 and GRC-UPMC 03, UPMC Université Paris 06 F-75005, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Beaugerie
authors.affiliation: Department of Gastroenterology, Henri Mondor Hospital, UPEC, Creteil, France.
authors.forename: Aurelien
authors.initials: A
authors.lastname: Amiot
authors.affiliation: Department of Gastroenterology, Hôpital Saint-Eloi, University Hospital of Montpellier, Montpellier, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Altwegg
authors.affiliation: Department of Gastroenterology, Rouen University and Hospital, Rouen, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Savoye
authors.affiliation: Department of Gastroenterology, Cochin Hospital, University Paris 5 Descartes, Paris, France.
authors.forename: Vered
authors.initials: V
authors.lastname: Abitbol
authors.affiliation: Department of Gastroenterology, Pontchaillou Hospital and Rennes University, Rennes, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Bouguen
authors.affiliation: Department of Digestive Diseases, Institut Mutualiste Montsouris, Université Paris-Descartes, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Simon
authors.affiliation: Department of Digestive Surgery, Rangueil University Hospital, University of Toulouse, Toulouse, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Duffas
authors.affiliation: Department of Gastroenterology and Clinical Nutrition, Nice University Hospital, University of Nice Sophia-Antipolis, Nice, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Hébuterne
authors.affiliation: Department of Gastroenterology, Hospices Civils de Lyon and University Claude Bernard Lyon 1, Pierre-Benite, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Nancey
authors.affiliation: Department of Gastroenterology, Saint-Etienne University Hospital, Saint-Etienne, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Roblin
authors.affiliation: Institute of Pathology, Lille University Hospital, Lille, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Leteurtre
authors.affiliation: Department of Hepato-Gastroenterology, University Hospital Estaing of Clermont-Ferrand, Université d'Auvergne, Clermont-Ferrand, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Bommelaer
authors.affiliation: Department of Digestive Surgery, Saint-Antoine Hospital, University Paris 6 Pierre and Marie Curie, Paris, France.
authors.forename: Jeremie H
authors.initials: JH
authors.lastname: Lefevre
authors.affiliation: Digestive Surgery and Liver Transplant Unit, Henri Mondor Hospital, UPEC, Creteil, France.
authors.forename: Francesco
authors.initials: F
authors.lastname: Brunetti
authors.affiliation: Department of Digestive Surgery, Hôpital Saint-Eloi, University Hospital of Montpellier, Montpellier, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Guillon
authors.affiliation: Department of Gastroenterology, IBD and Nutrition Support, Beaujon Hospital, University Paris 7 Denis Diderot, Clichy, France.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Bouhnik
authors.affiliation: Inserm U954 and Department of Gastroenterology, Université de Lorraine, Nancy, France. Electronic address: peyrinbiroulet@gmail.com.
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000453:epidemiology*; D003251:Constriction, Pathologic / Q000150:complications*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
keywords: CD; Carcinogenesis; Colon Cancer Risk Factors; GETAID Study; UC