title: Epithelial Dysplasia and Cancer in IBD Strictures.
abstract: BACKGROUND
  Colonic strictures and epithelial dysplasia are both known risk factors for the occurrence of colorectal cancer in inflammatory bowel disease (IBD) patients. The aim of the present work was to study colonic stricture as a risk factor for the occurrence of epithelial dysplasia and colonic adenocarcinoma.
  
  
  METHODS
  In a case-control study among 53568 IBD patients undergoing colonoscopy, we compared the prevalence of strictures among cases with dysplasia or adenocarcinoma and controls without such complications by calculating odds ratios (ORs) and their 95% confidence intervals (CIs). Multivariate logistic regressions were used to assess the joint influence of multiple predictor variables (age, sex, IBD type and stricture) on the occurrence of colonic dysplasia or adenocarcinoma.
  
  
  RESULTS
  The prevalence of strictures was 1.06% in ulcerative colitis (UC) and 8.71% in Crohn's disease (CD, OR 11.09, 95% CI 9.72-12.70). The prevalence of dysplasia was 3.22% in UC and 2.08% in CD (OR 0.75, 95% CI 0.65-0.86). The prevalence of dysplasia was similar in IBD patients with and without stricture: 2.82 and 2.41%, respectively. The prevalence of cancer was higher in IBD patients with than without stricture: 0.78 and 0.11%, respectively (OR 6.87, 95% CI 3.30-12.89). In the multivariate analysis, old age, male sex and UC, but not stricture, were all significantly and independently associated with dysplasia. Old age, dysplasia and stricture were significantly and independently associated with cancer.
  
  
  CONCLUSIONS
  The prevalence of epithelial dysplasia is not generally increased in IBD patients with strictures.
authors.affiliation: Oregon Health & Science University, Portland, OR, USA Oregon Health & Science University, Portland, OR, USA sonnenbe@ohsu.edu.
authors.forename: Amnon
authors.initials: A
authors.lastname: Sonnenberg
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, TX, USA University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Genta
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000473:pathology; D007415:Intestinal Obstruction / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011230:Precancerous Conditions / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
keywords: Colon cancer; dysplasia; epidemiology; histopathology of inflammatory bowel disease; intestinal strictures