Risk for Colorectal Neoplasia in Patients With Colonic Crohns Disease and Concomitant Primary Sclerosing Cholangitis
Clinical Gastroenterology and Hepatology ,
Braden B et al. – Primary sclerosing cholangitis (PSC) does not seem to increase the risk for dysplasia of the colon in patients with colonic Crohn's disease.Methods
- The authors performed a retrospective review of data from a tertiary care hospital on 166 patients with PSC and inflammatory bowel disease; 120 had concomitant ulcerative colitis, 35 had Crohn's disease, and 11 had indeterminate colitis.
- The controls comprised 114 patients with colonic involvement of Crohn's disease and 102 patients with ulcerative colitis.
- The main outcome parameter was the development of colorectal cancer or intraepithelial neoplasia.
- Only 1 patient with colonic Crohn's disease and concomitant PSC developed dysplasia in an adenomatous polyp during a median follow-up of 10 years (range, 7–16 years).
- In contrast, 2 cancers and 8 cases of colorectal dysplasia were diagnosed in patients with ulcerative colitis and PSC during a median follow up of 11 years (range, 8–16 years); the crude annual incidence of dysplasia or colorectal cancer was 1 in 150 patients with ulcerative colitis.
- Among patients with colonic Crohn's disease without PSC, 2 developed colorectal cancer during follow-up.
- The presence of PSC did not increase the risk of developing colorectal dysplasia in patients with Crohn's disease (P = 1.00).