IBD Patients Benefit from More Frequent Colonoscopies

Earlier and more frequent colonoscopies reduce colon cancer incidence and mortality in patients with inflammatory bowel disease (IBD), research shows.

Ashwin Ananthakrishnan, M.D., MBBS, MPH, assistant professor of medicine at Massachusetts General Hospital, in Boston, authored a study which examined whether colonoscopies affect the risk of colon cancer in patients with IBD. Patients with IBD are at increased risk for developing colon cancer, and guidelines from the American Society for Gastrointestinal Endoscopy and the American Gastroenterological Association recommend that patients with ulcerative colitis begin screening about eight years after diagnosis and every one to three years thereafter.

“The aim of our study was to identify whether colonoscopy alters the risk for CRC in patients with IBD,” said Ananthakrishnan. “We postulated that colonoscopy may reduce CRC in patients with IBD by either allowing removal of dysplastic lesions or by facilitating referral to surgery at the stage of dysplasia.”

Ananthakrishnan and his colleagues performed a cohort study that involved 6,823 patients with IBD that had received at least three years of follow-up care. During that three year period, 2,764 patients had undergone a colonoscopy. The study had a mean follow-up of eight years, during which 154 patients developed colon cancer. Researchers found that the difference between patients who did receive a colonoscopy and those who did not was statistically significant. Patients who had recently undergone a colonoscopy had a colon cancer incidence rate of 1.6 percent, compared to a rate of 2.7 percent among patients who did not receive a colonoscopy.

Colonoscopies not only prevented the occurrence of colon cancer in IBD patients, they also seemed to benefit patients who developed colon cancer. Among the 154 participants that developed colon cancer during the course of the study, 42 of them had recently undergone a colonoscopy. Ananthakrishnan noted that the rate of mortality was much lower among those 42 participants than it was among the 112 that did not receive a colonoscopy.

The findings of this study were presented at the 2014 meeting of the American College of Gastroenterology (Source: Gastroenterology & Endoscopy News).

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