Preoperative dysplasia among patients with ulcerative colitis undergoing colectomy was linked to a low risk for undetected synchronous colorectal cancer in a study presented at the American Society of Colon and Rectal Surgeons Annual Meeting in Phoenix.
Researchers evaluated the medical records of 2,130 patients with ulcerative colitis (UC) who underwent proctocolectomy, restorative proctocolectomy or total colectomy between August 1993 and July 2012. Preoperative colorectal dysplasia was detected in 15% of the cohort.
“The literature to date varies widely with regard to the importance of dysplasia as a marker for colorectal cancer (CRC) at the time of colectomy,” the researchers wrote. “This study aims to accurately characterize the extent to which the preoperative detection of dysplasia is associated with undetected CRC in patients with UC.”
Undetected CRC was observed in 10 patients, including six cases located in the ascending colon, two in the transverse colon, one in the descending colon and one in the rectum. There was no incidence of multiple cancers. Investigators calculated a 1.8% risk for undetected CRC among patients with preoperative low-grade and a 6.9% risk among those with preoperative high-grade dysplasia.
“This is the largest report to date analyzing the risk of undetected CRC in patients with UC and preoperative dysplasia,” the researchers wrote. “The presence of dysplasia in our study was associated with a very low risk of CRC at the time of colectomy. Our findings will help inform the decision-making process for patients with UC who are considering intensive surveillance vs. surgical intervention after a diagnosis of dysplasia.”
For more information:
Murphy J. S41: Dysplasia in Ulcerative Colitis as a Predictor of Undetected Synchronous Colorectal Cancer: Is the Risk Lower Than We Think? Presented at: The American Society of Colon and Rectal Surgeons Annual Meeting 2013; April 27–May 1, Phoenix.