Major Finding: In patients with primary sclerosing cholangitis and inflammatory bowel disease, the occurrence of colonic neoplasms per 100 patient-years of follow-up was 21.5 within 2 years, 20.5 at 2-4 years, 19.3 at 4-6 years, 16.8 at 6-8 years, and 20.4 at 8-10 years.
Data Source: A review of data from 54 patients seen at the Mayo Clinic, Rochester, Minn., for primary sclerosing cholangitis and inflammatory bowel disease and later diagnosed with colonic neoplasms.
Disclosures: Dr. Thackeray said that she had no financial conflicts to disclose.
SAN ANTONIO — Patients with primary sclerosing cholangitis and inflammatory bowel disease were as likely to develop colon cancer within 2 years of diagnosis as they were within 8-10 years of diagnosis, based on data from 54 patients.
Yearly colonoscopies are often recommended for patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD), but the evidence to support early screening has been limited, said Dr. Erin Thackeray of the Mayo Clinic in Rochester, Minn.
In this study, Dr. Thackeray and her colleagues reviewed medical charts from 54 adults with PSC and IBD who were seen at the Mayo Clinic between 1995 and 2005 and were later diagnosed with colonic neoplasms. Average age at the time of colon cancer diagnosis was 51 years, and 70% of the patients were male.
The occurrence of colonic neoplasms per 100 patient-years of follow-up was 21.5 within 2 years, 20.5 at 2-4 years, 19.3 at 4-6 years, 16.8 at 6-8 years, and 20.4 at 8-10 years.
Fourteen patients had colon cancer: two in the cecum, five in the ascending colon, four in the transverse colon, and three in the rectosigmoid colon. The cancers included two at stage 1, four at stage IIA, four at stage IIIB, two at stage IIIC, and two at stage IV.
Another 7 had high-grade dysplasia, 3 had dysplasia-associated lesions or a mass, and 30 had low-grade dysplasia.
The study population included 37 patients with ulcerative colitis, 6 who had Crohn's disease with colonic involvement, and 11 with indeterminate colitis. A total of 38 patients had IBD diagnosed prior to PSC by a median of 10.8 years, while 9 patients had PSC diagnosed before IBD b y a median of 4 years, and 7 patients were diagnosed simultaneously with both conditions.
The study was limited by its small size, but the results “support early and aggressive screening for colon cancer” in this patient population, Dr. Thackeray said.