Colorectal cancer risk and mortality in patients with ulcerative colitis

doi:10.1016/0016-5085(92)91163-X

Gastroenterology

Volume 103, Issue 5, November 1992, Pages 1444-1451

https://doi.org/10.1016/0016-5085(92)91163-X Get rights and content

Abstract

A regional inception cohort of 1161 ulcerative colitis (UC) patients was followed up from diagnosis to the end of 1987. The follow-up rate for death and occurrence of cancer was 99.9% (median observation time, 11.7 years; range, 0–26 years). One hundred forty-one deaths were observed, 26 caused by UC or complications thereof. No significant excess mortality was found after the first year, but in the year of diagnosis the relative risk of death was 2.4 (P < 0.001). The cumulative colectomy rate 25 years after diagnosis was 32.4%. The initial extent of disease significantly influenced the colectomy probability, being 35% in total colitis, 19% in substantial colitis, and 9% in distal colitis within the first 5 years after diagnosis. Six patients developed colorectal cancer within the observation period. Compared with the expected number of 6.6, the relative risk for patients with UC was 0.9. The calculated cumulative cancer incidence was 3.1% after 25 years (95% confidence limits, 0.0–6.8). The calculated lifetime risk (0–74 years) for development of colorectal cancer was 3.5% for UC patients compared with 3.7% for the Danish population. It is concluded that with an active approach to medical and surgical treatment, as practiced here, patients whose colons are left intact bear no significantly increased risk of colorectal malignancy.

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A retrospective study enrolling patients with a definitive diagnosis (DD) of UC or Unclassified Colitis (UnC) in the 2001-03 Navarra cohort.
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Ulcerative colitis (UC) is a chronic inflammatory disorder that has been increasingly recognized in children as an important gastrointestinal disorder with significant morbidities. The multifactorial etiology of pediatric UC includes both environmental and host factors. The disease is mainly limited to the colon but can be complicated by extraintestinal manifestations. Colectomy is curative; however, medical therapy can induce remission and maintain health. Surveillance for premalignant change in the colon is necessary. The ultimate goal is symptom control and mucosal healing. Recent multicenter studies have contributed much data toward understanding pediatric UC and how best to treat it.
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: Supported by grants from Aage Louis Hansen's Mindefond, Direktør Emil C Hertz og hustru Inger Hertz's Fond, Fonden til fremme af klinisk Forskning, University of Copenhagen.

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Colorectal cancer risk and mortality in patients with ulcerative colitis

Abstract

Gastroenterology

Gastroenterology

Lancet

Gastroenterology

Gastroenterology

Gastroenterology

Gastroenterology

Gastroenterology

Lancet

Gastroenterology

Course and prognosis of ulcerative colitis. Part IV. Carcinoma of the colon

Gut

Local complications of ulcerative colitis: stricture, pseudopolyposis and carcinoma of colon and rectum

Br Med J

Cancer risk and life expectancy of children with ulcerative colitis

N Engl J Med

Cancer risk in ulcerative colitis

Ann Surg