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Pseudopolyps do not predict neoplasia in patients with IBD
An analysis of 20 years of data — published in Gastroenterology — found that pseudopolyps are not associated with advanced colorectal neoplasia in patients with inflammatory bowel disease.
Researchers feel that their findings could impact how patients with IBD undergo screening colonoscopies, particularly in Europe, where current guidelines recommend patients with pseudopolyps receive screenings more frequently.
“This is very good news for the IBD patient with pseudopolyps, as their surveillance colonoscopies will likely be affected by these results,” Steven H. Itzkowitz, MD, FACP, FACG, AGAF, from the department of gastroenterology at the Icahn School of Medicine at Mount Sinai, said in a press release. “We hope that doctors treating these IBD patients would be less fearful of colon cancer risk in a colon with [pseudopolyps] and forego shortened intervals of surveillance as a result of our findings, lending to improved quality of life and lower health care costs.”
Investigators conducted a retrospective cohort study of patients with IBD who underwent surveillance for colorectal neoplasia from 1997 to 2017 at seven hospitals in New York and the Netherlands. They included patients who had confirmed colonic disease with a duration of eight years or more and no prior history of colorectal neoplasia or colectomy. The primary outcome was occurrence of advanced colorectal neoplasia according to pseudopolyp status, and the secondary outcomes were occurrence of colorectal neoplasia and colectomy.
Of the overall cohort (n = 1,582), 462 patients had pseudopolyps (29.2%). Although pseudopolyps were associated with more severe inflammation (adjusted OR = 1.32; 95% CI, 1.13–1.55), greater disease extent (aOR = 1.92; 95% CI, 1.34–2.74), and lower likelihood of primary sclerosing cholangitis (aOR = 0.38; 95% CI, 0.26–0.55), they were not independently associated with advanced colorectal neoplasia (aOR = 1.17; 95% CI, 0.59–2.31).
The rate of colectomy was higher among patients with pseudopolyps (P = .01), possibly because patients with refractory disease undergo surgery, according to the press release. – by Alex Young
Disclosures: Itzkowitz reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.