What should be the protocol to manage indefinite dysplasia in IBD?
From Cancer Guidelines Wiki
Guideline contents > What should be the protocol to manage indefinite dysplasia in IBD?
Information on authorship and revision
Last modified:
13 March 2013 06:13:40
Author(s):
- Dr William Connell MB BS FRACP — Author
- Professor Michael Kamm MB BS MD FRCP FRACP — Co-author
- Professor James Kench — Co-author
- Dr Rupert W Leong MB BS MD FRACP AGAF — Co-author
- Dr Alissa Walsh MBBS (Hons) FRACP — Co-author
- Cancer Council Australia Surveillance Colonoscopy Guidelines Working Party — Co-author
Contents |
What should be the protocol to manage indefinite dysplasia in IBD?
If Indefinite dysplasia (ID) is diagnosed, the rate of progression to a higher grade of dysplasia or carcinoma is unusual. At St Mark’s Hospital, 1/23 patients with ID (4%) eventually developed carcinoma and five (22%) developed LGD after nine years follow-up.[1] In contrast, data from New York showed that the five year rate of progression from indefinite dysplasia to HGD or cancer was 9%.[2] If a biopsy is diagnosed as indefinite for dysplasia by two gastrointestinal pathologists, follow-up surveillance colonoscopy, preferably with chromoendoscopy, at six months is reasonable, and thereafter at annual intervals.
Evidence summary and recommendations
| Evidence summary | Level | References |
|---|---|---|
| The predictive value of indefinite dysplasia in flat mucosa for imminent cancer is low. | II | [1], [2] |
| Recommendation | Grade |
|---|---|
 Indefinite dysplasia in flat mucosa does not require surgery, but follow-up colonoscopic surveillance is justified, preferably with chromoendoscopy, at more frequent intervals.
|
B |
References
- ↑ 1.0 1.1 Rutter MD, Saunders BP, Wilkinson KH, Rumbles S, Schofield G, Kamm MA, et al. Thirty-year analysis of a colonoscopic surveillance program for neoplasia in ulcerative colitis Gastroenterology 2006 Apr;130(4):1030-8 [Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16618396].
- ↑ 2.0 2.1 Ullman T, Croog V, Harpaz N, Hossain S, Kornbluth A, Bodian C, et al. Progression to colorectal neoplasia in ulcerative colitis: effect of mesalamine Clin Gastroenterol Hepatol 2008 Nov;6(11):1225-30; quiz 1177 [Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18848502].
Appendices
 View body of evidence
|
 View literature search documentation
|
- Statements regarding the inclusion/exclusion of issues should be clearly supported by scientific evidence, and specifically outline the relevance of the suggested material to the guidelines.
- If you have identified any gaps or errors in the content please suggest suitable text for inclusion.
- Use the blue 'Submit new evidence'-button to submit further/newly published evidence to be considered.
If you create a user account, your comments can be attributed to you and you also get alerts on any replies to your comments.
How to post a public comment
1) Use the blue 'Make a new comment' link below
2) Fill in the empty boxes
3) Press 'save page' to post your comment!