Abstract
One hundred twenty-seven patients were studied, representing the unselected population of patients with ulcerative colitis from a defined catchment area of about 70,000 inhabitants during 1961-1983. Seventy-seven patients had total colitis, and 50 patients had left-sided colitis. No prophylactic colectomy was performed. Despite this and a comprehensive follow-up of patients with long-standing, extensive colitis, primary colorectal carcinomas were diagnosed in only three patients, all of whom had total colitis. This was significantly (p less than 0.001) more than the expected number of patients with colorectal cancer in this subgroup, namely, 0.13. There were no deaths in colorectal carcinoma. Factors determining completeness of inclusion are discussed, and it is concluded that, in an unselected series of patients with ulcerative colitis, close cancer surveillance is indicated, although prophylactic surgery does not seem to be generally warranted.
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Selected References
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- Bartram C. I., Walmsley K. A radiological and pathological correlation of the mucosal changes in ulcerative colitis. Clin Radiol. 1978 May;29(3):323–328. doi: 10.1016/s0009-9260(78)80079-8. [DOI] [PubMed] [Google Scholar]
- Broström O., Löfberg R., Ost A., Reichard H. Cancer surveillance of patients with longstanding ulcerative colitis: a clinical, endoscopical, and histological study. Gut. 1986 Dec;27(12):1408–1413. doi: 10.1136/gut.27.12.1408. [DOI] [PMC free article] [PubMed] [Google Scholar]
- CARLESON R., FRISTEDT B., PHILIPSON J. Ulcerative colitis; a follow-up investigation of a 20-year primary material. Acta Med Scand. 1962 Dec;172:647–656. doi: 10.1111/j.0954-6820.1962.tb07204.x. [DOI] [PubMed] [Google Scholar]
- Coran A. G. New surgical approaches to ulcerative colitis in children and adults. World J Surg. 1985 Apr;9(2):203–213. doi: 10.1007/BF01656313. [DOI] [PubMed] [Google Scholar]
- Course and prognosis of ulcerative colitis: Part IV Carcinoma of the colon. Gut. 1964 Feb;5(1):15–22. doi: 10.1136/gut.5.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DAWSON I. M., PRYSE-DAVIES J. The development of carcinoma of the large intestine in ulcerative colitis. Br J Surg. 1959 Sep;47:113–128. doi: 10.1002/bjs.18004720202. [DOI] [PubMed] [Google Scholar]
- Gilat T., Zemishlany Z., Ribak J., Bennaroya Y., Lilos P. Ulcerative colitis in the Jewish population of Tel-Aviv Uafo. II: The rarity of malignant degeneration. Gastroenterology. 1974 Nov;67(5):933–938. [PubMed] [Google Scholar]
- Greenstein A. J., Sachar D. B., Smith H., Pucillo A., Papatestas A. E., Kreel I., Geller S. A., Janowitz H. D., Aufses A. H., Jr Cancer in universal and left-sided ulcerative colitis: factors determining risk. Gastroenterology. 1979 Aug;77(2):290–294. [PubMed] [Google Scholar]
- Katzka I., Brody R. S., Morris E., Katz S. Assessment of colorectal cancer risk in patients with ulcerative colitis: experience from a private practice. Gastroenterology. 1983 Jul;85(1):22–29. [PubMed] [Google Scholar]
- Kewenter J., Ahlman H., Hultén L. Cancer risk in extensive ulcerative colitis. Ann Surg. 1978 Dec;188(6):824–828. doi: 10.1097/00000658-197812000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lennard-Jones J. E. Compliance, cost, and common sense limit cancer control in colitis. Gut. 1986 Dec;27(12):1403–1407. doi: 10.1136/gut.27.12.1403. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lennard-Jones J. E., Morson B. C., Ritchie J. K., Williams C. B. Cancer surveillance in ulcerative colitis. Experience over 15 years. Lancet. 1983 Jul 16;2(8342):149–152. doi: 10.1016/s0140-6736(83)90129-0. [DOI] [PubMed] [Google Scholar]
- MACDOUGALL I. P. THE CANCER RISK IN ULCERATIVE COLITIS. Lancet. 1964 Sep 26;2(7361):655–658. doi: 10.1016/s0140-6736(64)92474-2. [DOI] [PubMed] [Google Scholar]
- Prior P., Gyde S. N., Macartney J. C., Thompson H., Waterhouse J. A., Allan R. N. Cancer morbidity in ulcerative colitis. Gut. 1982 Jun;23(6):490–497. doi: 10.1136/gut.23.6.490. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rutegård J., Ahsgren L., Janunger K. G. Ulcerative colitis. Mortality and surgery in an unselected population. Acta Chir Scand. 1988 Mar;154(3):215–219. [PubMed] [Google Scholar]
- Rutegård J., Ahsgren L., Stenling R., Janunger K. G. Ulcerative colitis. Cancer surveillance in an unselected population. Scand J Gastroenterol. 1988 Mar;23(2):139–145. doi: 10.3109/00365528809103958. [DOI] [PubMed] [Google Scholar]
- Turunen M. J., Järvinen H. J. Cancer in ulcerative colitis: what failed in follow-up? Acta Chir Scand. 1985;151(8):669–673. [PubMed] [Google Scholar]
- Whelan G. Cancer risk in ulcerative colitis: why are results in the literature so varied? Clin Gastroenterol. 1980 May;9(2):469–476. [PubMed] [Google Scholar]