Risk of Ileoanal Pouch Cancer Is Greater in Familial Adenomatous Polyposis Than in Ulcerative Colitis
Douglas K. Rex, MD, MASGE, reviewing Sriranganathan D, et al. Dig Liver Dis 2022 Jul 8.
This report identified 46 studies that included 19,964 patients with ulcerative colitis (UC) in whom 73 cases of pouch cancer occurred and 3741 patients with familial adenomatous polyposis (FAP) in whom 68 cases of pouch cancer developed. The pooled incidence was 0.3% in UC and 1% in FAP. In UC, 59% of cancers were in the pouch body versus 24% in the anal transition zone.
COMMENTThese data indicate that pouch cancer risk is greater in patients with FAP than those with UC, justifying surveillance intervals of every 1 to 2 years in patients with FAP, depending on the polyp burden. Longer intervals may be appropriate in patients with UC, with adjustments for factors such as the indication for colectomy (there is a higher risk of pouch dysplasia when neoplasia is the indication for colectomy vs uncontrolled disease activity) and results of previous pouch examinations.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Sriranganathan D, Vinci D, Pellino G, Segal JP. Ileoanal pouch cancers in ulcerative colitis and familial adenomatous polyposis: a systematic review and meta-analysis. Dig Liver Dis 2022 Jul 8. (Epub ahead of print) (https://doi.org/10.1016/j.dld.2022.06.013)
