Trends in Surveillance and Management of Dysplasia in IBD

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Trends in Surveillance and Management of Dysplasia in IBD
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Joseph Feuerstein, MD, AGAF

Click to view more from Gastroenterology Data Trends 2022. 

References
  1. Yeshi K, Ruscher R, Hunter L, et al. Revisiting inflammatory bowel disease: pathology, treatments, challenges and emerging therapeutics including drug leads from natural products. J Clin Med. 2020;9(5):1273. doi:10.3390/jcm9051273
  2. Xu F, Carlson SA, Liu Y, Greenlund KJ. Prevalence of inflammatory bowel disease among Medicare fee-for-service beneficiaries – United States, 2001-2018. MMWR Morb Mortal Wkly Rep. 2021;70(19):698-701.  doi:10.15585/mmwr.mm7019a2
  3. Rizzello F, Spisni E, Giovanardi E, et al. Implications of the westernized diet in the onset and progression of IBD. Nutrients. 2019;11(5):1033. doi:10.3390/nu11051033
  4. Stidham RW, Higgins PDR. Colorectal cancer in inflammatory bowel disease. Clin Colon Rectal Surg. 2018;31(3):168-178. doi:10.1055/s-0037-1602237
  5. Tariq H, Kamal MU, Sapkota B, et al. Evaluation of the combined effect of factors influencing bowel preparation and adenoma detection rates in patients undergoing colonoscopy. BMJ Open Gastroenterol. 2019;6(1):e000254. doi:10.1136/bmjgast-2018-000254
  6. May FP, Shaukat A. Time to add the "Q" (quality) factor to postpolypectomy surveillance? Gastroenterology. 2021;160(4):1007-1009. doi:10.1053/j.gastro.2020.12.067
  7. Murthy SK, Feuerstein JD, Nguyen GC, Velayos FS. AGA clinical practice update on endoscopic surveillance and management of colorectal dysplasia in inflammatory bowel diseases: expert review. Gastroenterology. 2021;161(3):1043-1051.e4. doi:10.1053/j.gastro.2021.05.063
  8. van der Laan JJH, van der Waaij AM, Gabriëls RY, Festen EAM, Dijkstra G, Nagengast WB. Endoscopic imaging in inflammatory bowel disease: current developments and emerging strategies. Expert Rev Gastroenterol Hepatol. 2021;15(2):115-126. doi:10.1080/17474124.2021.1840352
  9. Colombel JF, D'haens G, Lee WJ, Petersson J, Panaccione R. Outcomes and strategies to support a treat-to-target approach in inflammatory bowel disease: a systematic review. J Crohns Colitis. 2020;14(2):254-266. doi:10.1093/ecco-jcc/jjz131
  10. Atia O, Harel S, Ledderman N, et al. Risk of cancer in paediatric onset inflammatory bowel diseases: a nation-wide study from the epi-IIRN. J Crohns Colitis. 2022;16(5):786-795. doi:10.1093/ecco-jcc/jjab205
  11. Jess T, Simonsen J, Jørgensen KT, Pedersen BV, Nielsen NM, Frisch M. Decreasing risk of colorectal cancer in patients with inflammatory bowel disease over 30 years. Gastroenterology. 2012;143(2):375-381.e1. doi:10.1053/j.gastro.2012.04.016
  12. Di Palma JA, Bhandari R, Cleveland MV, et al. A safety and efficacy comparison of a new sulfate-based tablet bowel preparation versus a PEG and ascorbate comparator in adult subjects undergoing colonoscopy. Am J Gastroenterol. 2021;116(2):319-328. doi:10.14309/ajg.0000000000001020
  13. May FP, Shaukat A. State of the science on quality indicators for colonoscopy and how to achieve them. Am J Gastroenterol. 2020;115(8):1183-1190. doi:10.14309/ajg.0000000000000622
  14. Al-Bawardy B, Shivashankar R, Proctor DD. Novel and emerging therapies for inflammatory bowel disease. Front Pharmacol. 2021;12:651415. doi:10.3389/fphar.2021.651415
  15. Taxonera C, Olivares D, Alba C. Real-world effectiveness and safety of tofacitinib in patients with ulcerative colitis: systematic review with meta-analysis. Inflamm Bowel Dis. 2022;28(1):32-40. doi:10.1093/ibd/izab011
Publications
GI and Hepatology News
Topics
IBD & Intestinal Disorders
Author(s)
Joseph Feuerstein, MD, AGAF
Author(s)
Joseph Feuerstein, MD, AGAF

Click to view more from Gastroenterology Data Trends 2022. 

Click to view more from Gastroenterology Data Trends 2022. 

References
  1. Yeshi K, Ruscher R, Hunter L, et al. Revisiting inflammatory bowel disease: pathology, treatments, challenges and emerging therapeutics including drug leads from natural products. J Clin Med. 2020;9(5):1273. doi:10.3390/jcm9051273
  2. Xu F, Carlson SA, Liu Y, Greenlund KJ. Prevalence of inflammatory bowel disease among Medicare fee-for-service beneficiaries – United States, 2001-2018. MMWR Morb Mortal Wkly Rep. 2021;70(19):698-701.  doi:10.15585/mmwr.mm7019a2
  3. Rizzello F, Spisni E, Giovanardi E, et al. Implications of the westernized diet in the onset and progression of IBD. Nutrients. 2019;11(5):1033. doi:10.3390/nu11051033
  4. Stidham RW, Higgins PDR. Colorectal cancer in inflammatory bowel disease. Clin Colon Rectal Surg. 2018;31(3):168-178. doi:10.1055/s-0037-1602237
  5. Tariq H, Kamal MU, Sapkota B, et al. Evaluation of the combined effect of factors influencing bowel preparation and adenoma detection rates in patients undergoing colonoscopy. BMJ Open Gastroenterol. 2019;6(1):e000254. doi:10.1136/bmjgast-2018-000254
  6. May FP, Shaukat A. Time to add the "Q" (quality) factor to postpolypectomy surveillance? Gastroenterology. 2021;160(4):1007-1009. doi:10.1053/j.gastro.2020.12.067
  7. Murthy SK, Feuerstein JD, Nguyen GC, Velayos FS. AGA clinical practice update on endoscopic surveillance and management of colorectal dysplasia in inflammatory bowel diseases: expert review. Gastroenterology. 2021;161(3):1043-1051.e4. doi:10.1053/j.gastro.2021.05.063
  8. van der Laan JJH, van der Waaij AM, Gabriëls RY, Festen EAM, Dijkstra G, Nagengast WB. Endoscopic imaging in inflammatory bowel disease: current developments and emerging strategies. Expert Rev Gastroenterol Hepatol. 2021;15(2):115-126. doi:10.1080/17474124.2021.1840352
  9. Colombel JF, D'haens G, Lee WJ, Petersson J, Panaccione R. Outcomes and strategies to support a treat-to-target approach in inflammatory bowel disease: a systematic review. J Crohns Colitis. 2020;14(2):254-266. doi:10.1093/ecco-jcc/jjz131
  10. Atia O, Harel S, Ledderman N, et al. Risk of cancer in paediatric onset inflammatory bowel diseases: a nation-wide study from the epi-IIRN. J Crohns Colitis. 2022;16(5):786-795. doi:10.1093/ecco-jcc/jjab205
  11. Jess T, Simonsen J, Jørgensen KT, Pedersen BV, Nielsen NM, Frisch M. Decreasing risk of colorectal cancer in patients with inflammatory bowel disease over 30 years. Gastroenterology. 2012;143(2):375-381.e1. doi:10.1053/j.gastro.2012.04.016
  12. Di Palma JA, Bhandari R, Cleveland MV, et al. A safety and efficacy comparison of a new sulfate-based tablet bowel preparation versus a PEG and ascorbate comparator in adult subjects undergoing colonoscopy. Am J Gastroenterol. 2021;116(2):319-328. doi:10.14309/ajg.0000000000001020
  13. May FP, Shaukat A. State of the science on quality indicators for colonoscopy and how to achieve them. Am J Gastroenterol. 2020;115(8):1183-1190. doi:10.14309/ajg.0000000000000622
  14. Al-Bawardy B, Shivashankar R, Proctor DD. Novel and emerging therapies for inflammatory bowel disease. Front Pharmacol. 2021;12:651415. doi:10.3389/fphar.2021.651415
  15. Taxonera C, Olivares D, Alba C. Real-world effectiveness and safety of tofacitinib in patients with ulcerative colitis: systematic review with meta-analysis. Inflamm Bowel Dis. 2022;28(1):32-40. doi:10.1093/ibd/izab011
References
  1. Yeshi K, Ruscher R, Hunter L, et al. Revisiting inflammatory bowel disease: pathology, treatments, challenges and emerging therapeutics including drug leads from natural products. J Clin Med. 2020;9(5):1273. doi:10.3390/jcm9051273
  2. Xu F, Carlson SA, Liu Y, Greenlund KJ. Prevalence of inflammatory bowel disease among Medicare fee-for-service beneficiaries – United States, 2001-2018. MMWR Morb Mortal Wkly Rep. 2021;70(19):698-701.  doi:10.15585/mmwr.mm7019a2
  3. Rizzello F, Spisni E, Giovanardi E, et al. Implications of the westernized diet in the onset and progression of IBD. Nutrients. 2019;11(5):1033. doi:10.3390/nu11051033
  4. Stidham RW, Higgins PDR. Colorectal cancer in inflammatory bowel disease. Clin Colon Rectal Surg. 2018;31(3):168-178. doi:10.1055/s-0037-1602237
  5. Tariq H, Kamal MU, Sapkota B, et al. Evaluation of the combined effect of factors influencing bowel preparation and adenoma detection rates in patients undergoing colonoscopy. BMJ Open Gastroenterol. 2019;6(1):e000254. doi:10.1136/bmjgast-2018-000254
  6. May FP, Shaukat A. Time to add the "Q" (quality) factor to postpolypectomy surveillance? Gastroenterology. 2021;160(4):1007-1009. doi:10.1053/j.gastro.2020.12.067
  7. Murthy SK, Feuerstein JD, Nguyen GC, Velayos FS. AGA clinical practice update on endoscopic surveillance and management of colorectal dysplasia in inflammatory bowel diseases: expert review. Gastroenterology. 2021;161(3):1043-1051.e4. doi:10.1053/j.gastro.2021.05.063
  8. van der Laan JJH, van der Waaij AM, Gabriëls RY, Festen EAM, Dijkstra G, Nagengast WB. Endoscopic imaging in inflammatory bowel disease: current developments and emerging strategies. Expert Rev Gastroenterol Hepatol. 2021;15(2):115-126. doi:10.1080/17474124.2021.1840352
  9. Colombel JF, D'haens G, Lee WJ, Petersson J, Panaccione R. Outcomes and strategies to support a treat-to-target approach in inflammatory bowel disease: a systematic review. J Crohns Colitis. 2020;14(2):254-266. doi:10.1093/ecco-jcc/jjz131
  10. Atia O, Harel S, Ledderman N, et al. Risk of cancer in paediatric onset inflammatory bowel diseases: a nation-wide study from the epi-IIRN. J Crohns Colitis. 2022;16(5):786-795. doi:10.1093/ecco-jcc/jjab205
  11. Jess T, Simonsen J, Jørgensen KT, Pedersen BV, Nielsen NM, Frisch M. Decreasing risk of colorectal cancer in patients with inflammatory bowel disease over 30 years. Gastroenterology. 2012;143(2):375-381.e1. doi:10.1053/j.gastro.2012.04.016
  12. Di Palma JA, Bhandari R, Cleveland MV, et al. A safety and efficacy comparison of a new sulfate-based tablet bowel preparation versus a PEG and ascorbate comparator in adult subjects undergoing colonoscopy. Am J Gastroenterol. 2021;116(2):319-328. doi:10.14309/ajg.0000000000001020
  13. May FP, Shaukat A. State of the science on quality indicators for colonoscopy and how to achieve them. Am J Gastroenterol. 2020;115(8):1183-1190. doi:10.14309/ajg.0000000000000622
  14. Al-Bawardy B, Shivashankar R, Proctor DD. Novel and emerging therapies for inflammatory bowel disease. Front Pharmacol. 2021;12:651415. doi:10.3389/fphar.2021.651415
  15. Taxonera C, Olivares D, Alba C. Real-world effectiveness and safety of tofacitinib in patients with ulcerative colitis: systematic review with meta-analysis. Inflamm Bowel Dis. 2022;28(1):32-40. doi:10.1093/ibd/izab011
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Trends in Surveillance and Management of Dysplasia in IBD
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The prevalence of IBD has nearly doubled worldwide since the early 1990s, with popularity of the Western diet and increased alcohol consumption both being implicated in this rise within the United States and other countries.1-3 IBD serves as an important risk factor for developing colorectal cancer (CRC); risk of CRC rises from 2% 10 years after developing ulcerative colitis to 18% after 30 years.4

Successful bowel prep and highly skilled endoscopists are just some of the factors that affect screening results for CRC in IBD.5,6 New technologies and drugs are changing
the treatment paradigm. Endoscopic technologies and biologics for mucosal healing have elicited this shift to a treat-to-target approach.7-9 

Because IBD is occurring in younger populations, earlier targeted treatment of the inflamed state caused by IBD also has been emphasized.10 The earlier IBD is treated and put into remission, the less risk of CRC – with studies suggesting CRC rates for such patients may be comparable to that of the general population.11 As IBD prevalence increases across age groups, races and ethnicities, and geographical locations, gastroenterologists need to consider IBD as a feasible diagnosis and take action early on to mitigate their patients' risk of developing colon cancer.4,7

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