• Sofia Saraiva, Isadora Rosa, Joana Moleiro, João Pereira da Silva, Ricardo Fonseca, and António Dias Pereira.
• Department of Gastroenterology, Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E. (IPOLFG), Lisbon, Portugal.
• GE Port J Gastroenterol. 2021 Feb 1; 28 (2): 97-105.

IntroductionPatients with colonic inflammatory bowel disease (IBD) are at an increased risk for colorectal cancer (CRC), whereby surveillance colonoscopy is recommended.AimTo study the clinical and endoscopic variables associated with dysplasia in IBD patients.MethodsA cohort study was conducted on IBD patients who were part of a colonoscopy surveillance program between 2011 and 2016.ResultsA total of 342 colonoscopies were performed on 162 patients (105 with ulcerative colitis [UC] and 57 with Crohn's disease). Random biopsies were performed at least once on 81.5% of patients; 33.3% of the patients underwent chromoendoscopy (CE) at least once. Endoscopically resectable lesions were detected in 55 patients (34%), and visible lesions deemed unfit for endoscopic resection were found in 5 patients (3.1%). Overall, 62 dysplastic visible lesions (58 with low-grade dysplasia and 3 with high-grade dysplasia) and 1 adenocarcinoma were found in 34 patients. Dysplasia in random biopsies was present in 3 patients, the yield of random biopsies for dysplasia being 1.85%/patient (3/162), 1.75%/colonoscopy (6/342), and 0.25%/biopsy (9/3,637). Dysplasia detected in random biopsies was significantly associated with a personal history of visible dysplasia (p = 0.006). Upon univariate analysis, dysplasia was significantly associated with the type of IBD, the performance of random biopsies, and CE (p = 0.016/0.009/0.05, respectively). On multivariate analysis, dysplasia was associated with duration of disease.ConclusionOur data confirm that patients with long-standing IBD, in particular UC, should be enrolled in dysplasia surveillance programs, and that performing CE and random biopsies seems to help in the detection of colonic neoplastic lesions.Copyright © 2020 by S. Karger AG, Basel.

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