Disclosures: Kim reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
March 07, 2022
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Colonoscopy intervals of 1 to 3 years improve CRC outcomes in IBD patients

Disclosures: Kim reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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In patients with inflammatory bowel disease, colonoscopy within 3 years before colorectal cancer diagnosis was linked with early tumor stage detection, while colonoscopy within 1 year reduced overall all-cause mortality, according to data.

“Current U.S. and European Gastrointestinal society practice guidelines recommend colonoscopy for CRC surveillance in IBD patients at recurring periods ranging from 1 to 3 years. Approximately one-quarter of IBD patients in clinical practice receive guideline recommended colonoscopy surveillance,” Hyun-seok Kim, MD, MPH, of Baylor College of Medicine, and colleagues wrote in Clinical Gastroenterology and Hepatology. “Few studies have evaluated the effectiveness of varying colonoscopy intervals on other CRC outcomes in IBD patients such as stage at detection, receipt of CRC treatment or reducing mortality. Therefore, an additional well-powered study addressing these outcomes is needed.”

Likelihood of a late-stage colorectal cancer diagnosis: “Variable A” side- Colonoscopy within 1 year of IBD diagnosis; aOR = 0.4; “Variable B” side- Colonoscopy within 1-3 years of IBD diagnosis; aOR = 0.56

Seeking to provide further data in this area, Kim and colleagues performed a retrospective study of 566 patients with IBD and CRC (97.5% men, 77.2% white) who were part of a 2000-2015 cohort in the National Veterans Health Administration. They defined colonoscopy interval before CRC diagnosis as those performed within 1 year, 1 to 3 years, 3 to 5 years or none within 5 years.

According to analysis, 69.4% of patients did not have colonoscopy within 5 years of diagnosis, 9.7% had colonoscopy within 1 year, 17.7% within 1 to 3 years and 3.1% between 3 and 5 years. While 29.7% of diagnoses were early-stage and 29.9% of were late-stage, staging could not be determined in 40% of cases.

Compared with no surveillance, colonoscopy within 1 year (adjusted OR = 0.4; 95% CI, 0.2-0.82) and 1 to 3 years (aOR = 0.56; 95% CI, 0.32-0.98) were less likely to be diagnosed with late-stage CRC. Further, regardless of IBD type and duration, colonoscopy within 1 year correlated with reduced all-cause mortality (aHR = 0.56; 95% CI, 0.36-0.88).

“Colonoscopy within 3 years prior to CRC diagnosis compared with no colonoscopy was less likely to be diagnosed with late tumor stage,” Kim and colleagues concluded. “Colonoscopy within one year was associated with lower all-cause mortality than no colonoscopy. Our findings support the use of surveillance colonoscopy to improve CRC outcomes in IBD patients.”