Ulcerative colitis: how should patients with low-grade dysplasia be managed?

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Takeaway

  • For patients with ulcerative colitis with low-grade dysplasia (UC-LGD) under surveillance, annual incidence of progression to colorectal cancer (CRC) was low; high-risk features associated with dysplasia progression were primary sclerosing cholangitis, invisible dysplasia, distal location, and multifocal LGD.

Why this matters

  • Data on outcomes of patients with UC with LGD are limited.

Key results

  • In 14 surveillance cohort studies, 52 of 671 patients with UC-LGD developed CRC; pooled annual incidence for CRC was 0.8% and 1.8% for advanced neoplasia.
  • Risk for CRC was higher when LGD was diagnosed by gastrointestinal expert (1.5%) vs community pathologists (0.2%).
  • Dysplasia progression was significantly associated with concomitant primary sclerosing cholangitis, invisible vs visible...