Patients with long-standing ulcerative colitis have an increased risk of colorectal cancer.
Researchers from Japan evaluated the cumulative risk for the development of dysplasia or invasive cancer in these patients. They also assessed the effectiveness of surveillance colonoscopy in the Japanese population.
In this study, 217 patients received a total of 1027 surveillance colonoscopies between 1979 and 2001.
Patients with invasive cancer found in the study group were compared to those referred from hospitals without surveillance colonoscopy.
The team found that surveillance colonoscopy confirmed 15 patients with definite dysplasia.
|Risk of dysplasia:|
- 10 years = 3%
- 20 years = 10%
- 30 years = 16%
|British Journal of Cancer|
Of these, 5 had invasive cancer in the resected specimens.
They calculated that the cumulative risk for the development of invasive cancer was 0.5% at 10 years, 4% at 20 years, and 6% at 30 years.
The risk of development of definite dysplasia was 3% at 10 years, 10% at 20 years, and 16% at 30 years.
The researchers determined that all patients with invasive cancer in the surveillance group remained alive, compared with 3 out of 4 patients in the nonsurveillance group died.
Dr Hata's team concluded, "Our surveillance program is useful for detecting ulcerative colitis-associated colorectal cancer, and survival may be improved by surveillance colonoscopy".