P164 Dysplasia detection rates in a surveillance program real-world data from a tertiary referral center for inflammatory bowel diseases
Snir, Y.(1,2)*;Ollech, J.E.(1,2);Peleg, N.(1,2);Avni-Biron, I.(1,2);Eran-Banai, H.(1,2);Broitman, Y.(1,2);Sharar-Fischler, T.(1,2);Goren, I.(1,2);Zohar, L.(1,2);Dotan, I.(1,2);Yanai, H.(1,2);
(1)Rabin Medical Center, Division of Gastroenterology, Petach Tikva, Israel;(2)Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv, Israel;
Background
Patients with inflammatory bowel diseases (IBD) with an increased risk of developing colorectal carcinoma should undergo periodic surveillance colonoscopies. There is no quality metric for dysplasia detection rate (DDR) in IBD surveillance. We evaluated DDR in a dedicated surveillance program at a tertiary IBD referral center.
Methods
This cross-sectional study assessed DDR among consecutive patients with quiescent colitis enrolled in our surveillance program. Patients underwent high-definition colonoscopy with dye chromoendoscopy (DCE). A single specialized operator performed the procedures. Advanced dysplasia (AD) was defined as low-grade dysplasia ≥ 10mm, high-grade dysplasia, or colorectal cancer. We evaluated risk factors for dysplasia detection.
Results
Overall, 119 patients [female: 39.5%; median age: 54 years (IQR 43-66); median disease duration: 20 years (IQR 14-29)] underwent 151 procedures that revealed 206 lesions, of which 40 were dysplastic, and seven were considered AD. Per-procedure and per-lesion DDR were: 20.5%, and 19.4%, respectively. Per-procedure AD detection rate (ADDR) was 4.6%. Per-procedure dysplasia detection was associated with increased age at diagnosis at the index colonoscopy and past dysplasia or indefinite dysplasia, however, on multivariable analysis, only past dysplasia or indefinite dysplasia maintained a significant association (AdjOR 4.84, 95% CI 1.52-15.45, p=0.008). A Kudo pit pattern of II-V had a sensitivity of 92.5% for per-lesion dysplasia detection but a false positive rate of 64.8% (p<0.001).
Conclusion
DDR in a dedicated surveillance program in a real-world setting reached 20%. DDR should be considered a quality measure while surveying high-risk patients with IBD.