Meta-analysis: cancer risk of low-grade dysplasia in chronic ulcerative colitis.

Full Abstract

BACKGROUND:
The cancer risk of low-grade dysplasia (LGD) in chronic ulcerative colitis is variable and its management remain contentious.

AIM:
To determine the risk of cancer or any advanced lesion once LGD is diagnosed.

METHODS:
A MEDLINE, EMBASE and Pub Med search was conducted using the key words 'surveillance', 'colorectal cancer', 'low-grade dysplasia' and 'ulcerative colitis'. A random effects model of meta-analysis was used.

RESULTS:
Twenty surveillance studies had 508 flat LGD or LGD with dysplasia-associated lesion or mass. An average of 4.3 colonoscopies was performed/patient post-LGD diagnosis (range:
3-7.6). An average of 18 biopsies taken per colonoscopy (range:
9-24) detected 73 advanced lesions (cancer or high-grade dysplasia) pre-operatively. The cancer incidence was 14 of 1000 (95%

CI:
5.0-34) person years duration (pyd) and the incidence of any advanced lesion was 30 of 1000 pyd (95%

CI:
12-76). When LGD is detected on surveillance there is a ninefold risk of developing cancer (OR:
9.0, 95%

CI:
4.0-20.5) and 12-fold risk of developing any advanced lesion (OR:
11.9, 95%

CI:
5.2-27).

CONCLUSIONS:
The risk of developing cancer in patients with LGD is high. These estimates are valuable for decision-making when LGD is encountered on surveillance.

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Author information

Author/s: Thomas, T (T); Abrams, K A (KA); Robinson, R J (RJ); Mayberry, J F (JF);

Affiliation: Department of Gastroenterology, Digestive Diseases Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE4 5PW, UK.

Journal and publication information

Publication Type: Journal Article; Meta-Analysis; Review

Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther), published in England. (Language: eng)

Reference: 2007-Mar; vol 25 (issue 6) : pp 657-68

Dates: Created 2007/02/21; Completed 2007/06/29;

PMID: 17311598, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Adult
Aged
Chronic Disease
Colitis, Ulcerative - complications

Colorectal Neoplasms - etiology
Disease Progression
Humans
Precancerous Conditions - complications
Risk Factors

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