Colorectal neoplasia in long-standing ulcerative colitis – a prospective study from a low-prevalence area

Shivakumar, BM and Lakshmankumar, B and Rao, Lakshmi and Bhat, G and Suvarna, Deepak and Pai, Ganesh C (2013) Colorectal neoplasia in long-standing ulcerative colitis – a prospective study from a low-prevalence area. Colorectal Disease. pp. 1-7.

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Aim: Despite increasing recognition of ulcerative colitis (UC) in Asia in recent decades, reports on the occur- rence of colorectal neoplasia (CRN) in UC are scarce and surveillance for this complication is not routinely practised in this region. We aimed to assess the outcome of a newly initiated pilot screening programme for screening CRN among UC patients in India. Method: In this prospective study from an academic hospital setting, patients with UC at high risk of CRN were offered screening by magnifying chromocolonos- copy and the frequency of neoplastic lesions was assessed. Results: Twenty-nine (70.7%) of 41 eligible patients [a median age of 46 (interquartile range 36–54.5) years; 17 (58.6%) men] enrolled for surveillance; 41 colonos- copies were undertaken over 42 months. The median disease duration was 10 (interquartile range 7.5–14.5) years. Sixteen (55.1%) had extensive colitis. On initial screening, low-grade dysplasia (LGD) was seen in five (17.2%) and high-grade dysplasia (HGD) in three (10.3%). Of these three, one accepted proctocolectomy immediately, one underwent surgery for adenocarci- noma and one refused surgery. Twelve follow-up colo- noscopies in nine patients revealed three new LGD. Conclusions: High-grade dysplasia and subsequent adenocarcinoma can be detected with careful follow-up in Indian patients with long-standing UC but accep- tance of surveillance and subsequent therapy are suboptimal. We found evidence that screening and surveillance programmes are useful for detecting neoplasias in UC, and need to be customized for this region.

Item Type: Article
Uncontrolled Keywords: Ulcerative colitis; colorectal neoplasia screening; magnifying chromocolonoscopy.
Subjects: Medicine > KMC Manipal > Gastroenterology
Life Sciences > MLSC Manipal
Medicine > KMC Manipal > Pathology
Depositing User: KMC Manipal
Date Deposited: 02 Sep 2013 04:30
Last Modified: 02 Sep 2013 04:30

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