There has been substantial debate on the issue of how often one should undergo surveillance colonoscopy procedures to detect colorectal cancer (CRC) at an early stage and improve survival. Recent studies and advice from disease authorities suggest that patients who are not considered high-risk can be allowed a few more years in between procedures.
Now, a study led by University Medical Center Utrecht scientist Bas Oldenburg, MD, PhD, suggests that patients with active inflammatory bowel disease (IBD) who regularly have surveillance colonoscopy have a lower occurrence of interval CRC, meaning they can allow up to 5 years before having to undergo another surveillance colonoscopy. The study was recently published in the journal Clinical Gastroenterology and Hepatology and it is entitled “Incidence of Interval Colorectal Cancer Among Inflammatory Bowel Disease Patients Undergoing Regular Colonoscopic Surveillance“.
To arrive at this conclusion, Dr. Oldenburg and his fellow researchers conducted a retrospective analysis of IBD patient information. They gathered data on 1,273 IBD patients (34% Crohn’s disease, 63% ulcerative colitis, 3% unclassified) who underwent a total of 4,327 surveillance colonoscopies between January 1, 2000 and January 1, 2014. Patients were monitored between their first and last surveillance colonoscopy, bearing in mind procedure-related factors that may be linked to any incidence of CRC, such as inadequate procedures, inadequate surveillance, or inadequate management of dysplasia. According to a news release, true interval CRCs were defined as those “detected within the appropriate surveillance interval, after an adequately performed surveillance colonoscopy.”
Researchers found that 1.3 percent of the studied patients developed CRC, with the median interval between the last colonoscopy procedure and CRC diagnosis being 22 months.
“This study shows that the incidence of CRC among IBD patients enrolled in a surveillance program is low compared with previous studies, with only 17 cancers detected during 6,823 years of follow-up evaluation,” the researchers wrote. “This might support the longer surveillance interval of up to 5 years as recommended in the current [British Society of Gastroenterology] and European Crohn’s and Colitis Organization guidelines, although the fact that one third of all CRC cases appear to be interval carcinomas underscores the need to further identify risk factors associated with the development of interval cancer.”