ProSeCReT-IBD
Research type
Research Study
Full title
Multi-centre observational cohort study on surgical and oncological outcomes of patients with Inflammatory Bowel Disease who have undergone segmental colonic resections for dysplasia and cancer
IRAS ID
336404
Contact name
Omar Faiz
Contact email
Sponsor organisation
London North West University Healthcare NHS Trust
Duration of Study in the UK
8 years, 0 months, 5 days
Research summary
It is recognised that patients with Inflammatory Bowel Disease (IBD) are at an increased risk of developing colorectal cancer (CRC) compared to the general population. The risk factors for developing CRC in patients with IBD are:
extensive and severe disease, presence of dysplasia, strictures, advancing age, male sex, presence of concomitant primary sclerosing cholangitis (PSC), post-inflammatory polyps, and a family history of CRC.
Dysplasia is a precancerous change in the colon, and is classified into High Grade(HGD), Low Grade(LGD), or Indeterminate dysplasia(IND), with different rates of progression to cancer depending on its type, visibility, and how many locations (multi-focal/unifocal) it is found in. International guidelines recommend that patients with dysplasia that cannot be removed during colonoscopy, invisible HGD, or multi-focal LGD should undergo immediate removal of the entire colon and rectum in the form of proctocolectomy (gold standard).
In Ulcerative Colitis patients, this would nearly eliminate their risk of cancer and offer them a chance of a ‘cure’ for colitis. In Crohn’s colitis patients, although the risk of recurrence of Crohn’s elsewhere is still present, it is thought that this option would also eliminate their risk of developing other colon cancers from dysplasia. However, many patients are unwilling to undergo this major life-changing surgery with the possibility of a permanent stoma for risks that they
perceive to be low with many asking why just the problematic section of the colon could not be removed.
There is limited data currently on the outcomes of IBD patients who have only the problematic section of their colon removed for dysplasia and cancer(segmental resection), so the aim of this study is to collect this data prospectively and help clinicians and patients to have better informed consultations with shared decision making in the future.REC name
South Central - Oxford C Research Ethics Committee
REC reference
23/SC/0433
Date of REC Opinion
9 Jan 2024
REC opinion
Further Information Favourable Opinion