Risk for Colorectal Neoplasia Increased for Patients With IBD and Dysplasia

THURSDAY, Feb. 19, 2026 (HealthDay News) — Patients with inflammatory bowel disease (IBD) and dysplasia have an increased risk for future colorectal neoplasia (CRN), including colorectal dysplasia and cancer, according to a study published online Feb. 16 in Clinical Gastroenterology and Hepatology.

Jordan Axelrad, M.D. M.P.H., from the NYU Grossman School of Medicine in New York City, and colleagues conducted a nationwide cohort study using the Swedish Patient Register and the ESPRESSO histopathology cohort to identify patients diagnosed with IBD between 1969 and 2023 and examine the clinical course of dysplasia types. Patients were categorized according to their first incident dysplasia episode (no dysplasia [ND]; indefinite [IND]; low grade [LGD]; high grade [HGD]).

A total of 54,534 patients with IBD were identified, including 53,214 with ND and 1,320 with a first episode of dysplasia (264 IND; 1,031 LGD; and 25 HGD). The researchers found that 2.3 percent of ND patients had future advanced CRN during a median follow-up of 13.3 years compared with 5.3 and 8.3 percent of IND and LGD patients, respectively (adjusted hazard ratios, 1.85 and 3.51, respectively). Forty percent of those with HGD developed colorectal cancer (adjusted hazard ratio, 47.88). Male sex, younger age at diagnosis, extensive colitis, primary sclerosing cholangitis, and histologic inflammation were risk factors for future dysplasia.

“Our work provides robust, long-term data that can help doctors and patients make more informed decisions about the frequency of cancer screening and potential interventions,” Axelrad said in a statement.

Several authors disclosed ties to the biopharmaceutical industry.

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