S909 Risk Factors for Colorectal Dysplasia and Colorectal Cancer (CRC) Among Patients With Inflammatory Bowel Disease (IBD) Undergoing Surveillance Colonoscopy in a Tertiary Care Center

Abstract

Introduction: Patients with IBD are more likely to develop dysplasia and CRC than the general population. We aimed to evaluate risk factors for dysplasia and CRC among patients with IBD undergoing surveillance colonoscopy. Methods: We conducted a retrospective case-control study to evaluate risk factors for colorectal dysplasia/CRC in IBD patients who underwent surveillance colonoscopy in 2010-2020. Cases were patients with dysplasia/CRC found on surveillance colonoscopy and controls were those without. Dysplasia was limited to flat lesions and did not include dysplasia associated lesions/masses. Relevant data obtained from EMR included: age, gender, ethnicity, BMI, smoking status, medication hx, IBD subtype, diagnosis age, disease duration, clinical disease activity, previous IBD related surgery, h/o polyps, dysplasia, or CRC, h/o primary sclerosing cholangitis or extra-intestinal manifestations, family history of IBD, polyps, CRC, and genetic conditions. After summary statistics, logistic regression analysis was performed to examine the association between potential risk factors and incidence of dysplasia or CRC. Rstudio 4.0.2 was used for analysis. Results: 549 subjects were identified from our IBD database with 64 cases and 485 controls. The dysplasia/CRC group had a significantly larger proportion of males (67% vs 48%), patients with UC than CD (69% vs 47%), perianal disease (53% vs 25%), and were more likely to have moderate-severe disease vs remission-mild (36% vs 23%) than the control group. No significant differences were found between groups for the remaining variables. Univariate logistic regression model for each predictor variable of interest revealed statistically significant differences with gender (OR 2.25, 95% CI 1.31-3.97 p=0.004), IBD subtype (OR 2.44, 95% CI 1.42-4.35 p=0.002), disease activity (OR 1.86, 95% CI 1.06-3.21 p=0.028), and perianal disease (OR 3.49, 95% CI 2.05-5.97 p< 0.001). When fitting various multiple logistic regression models and adjusting for the three other variables, disease activity was no longer significant. Conclusion: Our case control study assessing risk factors for colorectal dysplasia or cancer in IBD found that gender, IBD subtype, and perianal disease are perhaps the most significant risk factors for this population. While previous cohorts have noted several of these as potential risk factors, perianal disease has not previously been considered a risk factor for dysplasia/CRC in IBD.