b'u From Page 97In337cases,stageatdiagnosiswas available.Amongthese,colonoscopy interval of less than one year reduced the risk of a late-stage disease diagnosis by 60% and screening within one to three years reduced the risk 44% compared to no colonoscopy. The researchers found noassociationbetweenrace/ethnicity, IBD type or extent, smoking or alcohol use, comorbidities or IBD facility vol-ume and tumor stage.Overall,87%ofveteranswithCRC received treatment, with the percentage rising to 96% among those with early- FIGURE 1: Pathophysiology of inflammatory events in IBDstagedisease.AmultivariateanalysisIBD: inflammatory bowel diseaserevealed the only significant variable in treatment for CRC was disease stage. Source: Rivera AP, Flores Monar GV, Islam H, Puttagunta SM, et. al. Ulcerative Colitis-Induced Colorectal Carcinoma: A Deleterious Concatenation. Cureus. 2022 Feb 26;14(2):e22636. doi: 10.7759/cureus.22636. During the study, 70% of veterans died,PMID: 35371788; PMCID: PMC8959421.with 23% of deaths related to CRC. The researchers found that colonoscopy interval did notto schedule frequent colonoscopies. Data from this significantly affect CRC-related mortality comparedstudy, the researchers said, can help patients appre-with no colonoscopy in any of the models. Whileciate the impact of colonoscopy on CRC outcomes.colonoscopy within one year of CRC diagnosis hadA recent international study published in Cureus a trend toward reduced CRC-related mortality, it wasdiscussedthelinkbetweenchronicinflamma-not determined to be significant. tion in UC and the link to cancer, noting Chronic Thestorywasdifferentforall-causemortality,inflammation has been linked to cancer, and chronic however. On an unadjusted basis, colonoscopy lesscolonic inflammation caused by IBD increases the than one year prior to CRC diagnosis decreased therisk of colorectal cancer (CRC). 2mortality risk 40% compared to no colonoscopy, aThe authors pointed out that, when CRC occurs in benefit maintained even after adjusting for lead-timeIBD patients, unlike sporadic CRC, the lesions are bias, tumor stage, treatment, and all covariates.difficult to identify because of mucosal alterations Notably,screeningwithinoneyearofdiagnosiscreated by inflammation. significantly reduced the risk of all-cause mortalityThe total prevalence ofIBD-associated CRCis comparedtoallotherscreeningintervals. Thenoincreasing due to the rapidly increasing frequency colonoscopy group and colonoscopy within one toof IBD, researchers wrote. Screening and surveil-three years groups both had 59% increase in mortal- lance colonoscopy in IBD patients is considered to ity risk, while the three to five years group had moreallow for the early diagnosis of dysplasia and cancer, than double the risk of the within one year group.improving the prognosis of IBD-related CRC by giv-The researchers concluded that their findings sup- ing patients proactive therapy.portcurrentpracticeguidelinesthatrecommend1Kim HS, Hernaez R, Sansgiry S, Waljee AK, Scott FI, Lewis JD, colonoscopy intervals from one year to three yearsEl-Serag HB, Hou JK. Comparative Effectiveness of Surveillance among patients with IBD who have extensive colitisColonoscopy Intervals on Colorectal Cancer Outcomes in a National or left-sided colitis. Cohort of Patients with Inflammatory Bowel Disease. Clin Gastroen-terol Hepatol. 2022 Feb 28:S1542-3565(22)00205-1. doi: 10.1016/j.Furthermore, the findings may bolster clinicians dis- cgh.2022.02.048. Epub ahead of print. PMID: 35240331.cussions with veterans with IBD, for whom colonos- 2Rivera AP, Flores Monar GV, Islam H, Puttagunta SM, et. al. Ulcer-copy is associated with significantly more embarrass- ative Colitis-Induced Colorectal Carcinoma: A Deleterious Concatena-ment and pain than in patients without IBD, the teamtion. Cureus. 2022 Feb 26;14(2):e22636. doi: 10.7759/cureus.22636. noted. Painful memories can make patients less eagerPMID: 35371788; PMCID: PMC8959421.105'