Low prevalence of colorectal neoplasia in microscopic colitis: A large prospective multi-center study.

Published on Jul 1, 2021in Digestive and Liver Disease4.088
· DOI :10.1016/J.DLD.2020.09.024
E. Borsotti1
Estimated H-index: 1
,
Brigida Barberio9
Estimated H-index: 9
(UNIPD: University of Padua)
+ 9 AuthorsGian Eugenio Tontini20
Estimated H-index: 20
(Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)
Sources
Abstract
BACKGROUND AND AIMS Microscopic colitis (MC) is the most frequent condition in subjects undergoing ileocolonoscopy for chronic non-bloody diarrhea (CNBD) in Western countries. Emerging evidence has shown a negative association between MC and colorectal cancer. Within this prospective multi-center study we have evaluated the risk of colorectal neoplasia in MC and non-MC patients with CNBD receiving ileocolonoscopy with high-definition plus virtual chromoendoscopic imaging and histopathological assessment. METHODS Patients with CNBD of unknown origin were prospectively enrolled in 5 referral centers in Northern Italy for ileocolonoscopy with high-definition and digital/optical chromoendoscopy plus multiple biopsies in each segment. The prevalence of colorectal neoplasia (cancer, adenoma, serrated lesion) in MC was compared to that observed in a control group including CNBD patients negative for MC, inflammatory bowel disease or eosinophilic colitis. RESULTS From 2014 and 2017, 546 consecutive CNBD patients were recruited. Among the 492 patients (mean age 53±18 years) fulfilling the inclusion criteria against the exclusion critieria, MC was the predominant diagnosis at histopathological assessment (8.7%: N=43, 28 CC, 15 LC). The regression model adjusted for age and gender showed a significant negative association between the diagnosis of CM and colorectal neoplasia (OR=0.39; 95% CI 0.22-0.67, p <0.001) with a 60% decreased risk of adenomatous and neoplastic serrated polyps as compared to the control group (n=412). CONCLUSION This multi-center study confirms MC as a low-risk condition for colorectal neoplasia. No surveillance colonoscopy program is to be performed for MC diagnosis.
📖 Papers frequently viewed together
References51
Newest
Data on malignancy in patients with collagenous colitis (CC) is scarce. We aimed to determine the incidence of cancers in patients with CC. In a two-stages, observational study, data on cancers in patients diagnosed with CC during 2000–2015, were collected from two cohorts. The risk was calculated according to the age-standardized rate for the first cohort and according to the standardized incidence ratio for the second cohort. The first cohort comprised 738 patients (394 from Scotland and 344 f...
Source
Microscopic colitis (MC), described for the first time in 1976 (1), is now recognized as a common cause of chronic diarrhea. MC includes 2 histologic entities: collagenous colitis (CC) and lymphocytic colitis (LC). A French study performed between 2005 and 2007 in the Somme department found a mean annual incidence of 7.9/105 inhabitants for the MC (5.3/105 for the CC and 2.6/105 for the LC) (2). This incidence was similar to that recorded for Crohn's disease (7.4/105) during the same period in t...
Source
#1Danila GuagnozziH-Index: 17
#2Gian Eugenio Tontini (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 20
Last. Luca PastorelliH-Index: 23
view all 3 authors...
Source
#1David Bergman (KI: Karolinska Institutet)H-Index: 11
#2Mark S. Clements (KI: Karolinska Institutet)H-Index: 29
Last. Jonas F. Ludvigsson (Örebro University)H-Index: 82
view all 6 authors...
BACKGROUND: Epidemiological studies of microscopic colitis have shown varying but increasing incidence rates. AIM: To assess the incidence of microscopic colitis in Sweden. METHODS: Nationwide cohort study performed in 1995-2015 based on biopsy reports. Age-specific and age-standardised incidence rates were calculated. RESULTS: We identified 13 844 patients with an incident diagnosis of microscopic colitis. Lymphocytic colitis (n = 9238) constituted 67% and collagenous colitis (n = 4606) 33% of ...
Source
#1Edoardo BorsottiH-Index: 1
#2Brigida Barberio (UNIPD: University of Padua)H-Index: 9
Last. Gian Eugenio TontiniH-Index: 20
view all 12 authors...
Background and aimsIleo-colonoscopy is the procedure of choice for chronic nonbloody diarrhea (CNBD) of unknown origin. Histological evaluation at different colonic sites is mandatory to assess the presence of microscopic colitis. However, the value of routine ileal biopsy on normal-appearing mucosa as assessed by means of standard-resolution white-light ileoscopy is controversial given its reported low diagnostic yield. Hence, we have assessed for the first time the accuracy of retrograde ileos...
Source
#1Stephan MiehlkeH-Index: 51
#2Bas Verhaegh (Maastricht University Medical Centre)H-Index: 1
Last. Andreas Münch (Linköping University)H-Index: 17
view all 6 authors...
Summary Microscopic colitis is a chronic inflammatory disease of the colon that frequently causes chronic watery diarrhoea that might be accompanied by abdominal pain, nocturnal diarrhoea, urgency, and faecal incontinence. These symptoms lead to poor quality of life and increased health-care costs. Diagnosis relies on histological examination of multiple biopsy samples from the colonic mucosa, which often show no or only few abnormalities on endoscopy. Two major histological subtypes can be dist...
Source
#1Alexander N. Levy (Tufts Medical Center)H-Index: 5
#2Nienke Z. Borren (Harvard University)H-Index: 10
Last. Ashwin N. Ananthakrishnan (Harvard University)H-Index: 78
view all 9 authors...
Background The long-term natural history of microscopic colitis (MC) (collagenous colitis (CC), lymphocytic colitis (LC)), traditionally considered relapsing but non-progressive diseases, is poorly defined. Whether persistent histologic inflammation in such diseases is associated with an increased risk of colorectal neoplasia (CRN) or extracolonic cancers has not been robustly established.
Source
#1Stefania Chetcuti Zammit (Mater Dei Hospital)H-Index: 9
#2Monique Cachia (Mater Dei Hospital)H-Index: 2
Last. Pierre Ellul (Mater Dei Hospital)H-Index: 20
view all 6 authors...
Background: Eosinophilic gastroenteropathy is an uncommon condition whose causes can be numerous and non-specific. The aim of the study was to characterize the presence of gastrointestinal disorders in the adult Maltese population and assess the degree of association with atopic diseases. Methods: Adult patients with gastrointestinal eosinophilia in the gastrointestinal tract on histology were identified and their clinical case notes were reviewed. Patients were interviewed and asked questions r...
Source
#2Steven P. BrownH-Index: 1
Last. Julian R.F. Walters (Imperial College London)H-Index: 49
view all 13 authors...
Chronic diarrhoea is a common problem, hence clear guidance on investigations is required. This is an updated guideline from 2003 for the investigations of chronic diarrhoea commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG). This document has undergone significant revision in content through input by 13 members of the Guideline Development Group (GDG) representing various institutions. The GRADE system was used to appraise the quality ...
Source
#2Alan C. Moss (University of Melbourne)H-Index: 63
1 ESGE recommends cold snare polypectomy (CSP) as the preferred technique for removal of diminutive polyps (size ≤ 5 mm). This technique has high rates of complete resection, adequate tissue sampling for histology, and low complication rates. (High quality evidence, strong recommendation.) 2 ESGE suggests CSP for sessile polyps 6 – 9 mm in size because of its superior safety profile, although evidence comparing efficacy with hot snare polypectomy (HSP) is lacking. (Moderate quality evidence, wea...
Source
Cited By1
Newest
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.