P453 Surveillance for colorectal dysplasia and neoplasia in Latin American patients with Ulcerative Colitis

Abstract Background colorectal cancer (CRC) in patients with inflammatory bowel disease (IBD) has worse prognostic features and a higher mortality rate compared to sporadic CRC. Screening colonoscopy is therefore an important tool to consider in this population. The aim of this study is to describe the findings of endoscopic surveillance of CRC in patients with IBD using the technology available in Latin American countries. Methods Descriptive, multicentre, cross-sectional, descriptive study conducted in multiple Latin American countries in patients with ulcerative colitis (UC) more than 8 years after diagnosis and ulcerative colitis with primary sclerosing cholangitis regardless of the time of diagnosis of colitis. Surveillance colonoscopies were performed according to the availability of technology in each country. Results 78 subjects, 50% women, from 5 countries (Colombia, Costa Rica, Peru, Ecuador, and Dominican Republic), with mean age 47.9 (range 20.01-89.71; SD 151.4) years, mean age at disease diagnosis of 34.7 (range 8.52-80.9; SD 14.08) years, and mean time of disease of 12.8 (range 4.6-56.8; SD 8.9) years. 57.7% (45/78) with extensive colitis, 8.9% (7/78) with a family history of colorectal cancer. 52.6% (41/78) on biologic therapy. 24.4% (19/78) current use of Azathioprine. 9% (7/78) of corticosteroids. 70.5% (55/78) oral mesalazine. In 5.1% it was used white light, 1.3% high resolution white light, 76.9% digital chromoendoscopy and 16.7% chromoendoscopy with staining. In those with digital chromoendoscopy, NBI was used in 38.3% (28/73), 37% (27/73) LCI/BLI, and 24.6% (14/73) I-Scan. It was found pseudopolyps in 50% (39/78), and 11.5% (9/78) stenosis. 7.7% (6/78) had a history of previous dysplasia. Regarding the Paris classification modified by SCENIC consensus, 28.2% (22/78) found 0-I lesions, 16 subjects were 0-I s, and 6 subjects 0-Ip. 5 subjects had 0-II lesions, of which 4 subjects in 0-IIa, and 1 in 0-IIc. 1 subject had lesion type 0-III. 1 subject had mixed lesions (0-IIa+0-IIc), 6.4% (5/78) lesion with ulceration, 10.2% (8/78) with disruption of lesion borders, with KUDO classification, Kudo III, 5.1 (4/78) Kudo IV and 3.8% (3/78) Kudo V. Endoscopic resectability was possible in all lesions. Histological findings were: (11/78) low grade dysplasia, (1/78) high grade dysplasia and (3/78) adenocarcinoma. As for the presence of dysplasia not visible in white light in random biopsies, it was only detected in (2/78). Conclusion in this first Latin American study, endoscopic techniques with digital chromoendoscopy with targeted biopsies were preferred, most were endoscopically visible and resectable lesions suggesting that the yield of targeted biopsies is superior to random biopsies.