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Dysplasia and Colorectal Cancer Surveillance in Ulcerative Colitis Patients in Latin America (LATAM): Real-World Data

2024; Oxford University Press; Volume: 7; Issue: 1 Linguagem: Inglês

10.1093/crocol/otae081

2631-827X

Viviana Parra-Izquierdo, William Otero Regino, Fabián Juliao Baños, Juan Sebastián Frías‐Ordoñez, Edgar Ibáñez Pinilla, Fabio Leonel Gil Parada, Hernando Marulanda Fernández, Lina Otero‐Parra, Elder Otero Ramos, Fabián Eduardo Puentes Manosalva, Gerardo Andrés Guzmán Rojas, Kenneth Ernest‐Suarez, Keyla Villa Ovalles, Juan Eloy Paredes Méndez, María Luisa Jara-Alaba, David Andrade Zamora, Manuel Alonso Ardila-Báez, Cristian Flórez-Sarmiento, Guillermo Veitía, Abel Sánchez, Lázaro Antonio Arango Molano, Fernando Fluxa, Natália Sousa Freitas Queiroz, María Stella Serrano-Moreno,

Microscopic Colitis

Abstract Background The prevalence of colorectal cancer (CRC) in patients with ulcerative colitis (UC) is higher than in the general population, in Latin America there is a progressive increase of UC, and information about CRC screening in inflammatory bowel disease (IBD) is scarce. The aim of this study was to analyze the findings of endoscopic surveillance of CRC in patients with IBD according to available technology. Methods Multicenter, cross-sectional, analytical study conducted in Latin American countries, in patients with UC, predominantly with more than 8 years of diagnosis and different degrees of disease activity. Surveillance colonoscopies were performed according to available technology. Risk factors for dysplasia detection were analyzed. Results One hundred and forty-four patients, 55.5% women, mean age 47.3 (range 17.1 to 90; SD 15.64) years and mean duration of disease 12.71 (range 0.64 to 57.13; SD 8.08) years. Forty-nine lesions were identified, 18 corresponded to dysplasia. The detection rate of dysplasia per lesion and per procedure was 36.7% and 12.5%, respectively. By logistic regression analysis, the duration of disease (OR 1.12;95%CI:1.047 to 1.215, P = .002) and the presence of post-inflammatory polyps (OR 3.4;95%CI:1.11 to 10.36, P = .031) were risk factors for higher detection of dysplasia. Digital chromoendoscopy was associated with greater detection of dysplasia (OR 4.99, 95%CI: 1.092 to 22.864, P = .038). Conclusions In our region, the duration of disease and the presence of post-inflammatory polyps were the factors with the highest association for dysplasia detection, and digital chromoendoscopy with directed biopsies was the technique of choice. The implementation of a specific surveillance program in colonoscopy in IBD is an effective strategy to achieve high detection rates.