From Dysplasia to Colorectal Cancer: Measuring Risk in IBD

Patients with inflammatory bowel disease (IBD) face a higher risk of colorectal neoplasia (CRN), including colorectal dysplasia and cancer (CRC). Although surveillance programs aim to reduce CRC incidence, the long-term outcomes associated with different dysplasia grades remain incompletely understood. To clarify this, a large cohort study evaluated the impact of baseline dysplasia on future CRC risk in 54,534 patients with IBD.

Over a median follow-up of 13.3 years, advanced CRN developed in 2.3% of patients without dysplasia, compared with 5.3% of those with indefinite dysplasia (adjusted hazard ratio [aHR], 1.85) and 8.3% of those with low-grade dysplasia (aHR, 3.51). Among patients with high-grade dysplasia, 40% progressed to CRC (aHR, 47.88). Male sex, younger age at IBD diagnosis, extensive colitis, primary sclerosing cholangitis, and histologic inflammation were identified as…