Abstract
Purpose
Cancer surveillance has been conducted in patients with ulcerative colitis (UC), and the number of operative cases of ulcerative colitis-associated colorectal cancer (UC-CRC) has been increasing. The aim of this study was to clarify the clinicopathological features and prognoses of UC-CRC patients and the relationship between surveillance colonoscopy and UC-CRC.
Methods
The clinical records of 1,274 UC patients who required surgery between 1984 and 2010 at a single institution were reviewed retrospectively. Of these, 83 patients had CRC (107 sections). All cases were extracted from the database, along with their clinicopathological data.
Results
The 5-year survival rate of the UC-CRC group was 89 %. The 5-year survival rate was 100 % in stages 0 and II, 96 % in stage I, 56 % in stage III, and 0 % in stage IV. Surveillance colonoscopy was performed for 40 of the 83 patients. Of 40 patients, 30 with UC who underwent surveillance colonoscopies and 22 of 43 patients without surveillance colonoscopies were in stages 0 to I (P = 0.04).
Conclusion
The number of UC-CRC patients who are diagnosed by surveillance colonoscopy is increasing, and many of them are detected in the very early stages (stages 0 or I). Thus, the survival rate of UC-CRC is better than before. Surveillance colonoscopy proofs efficient as CRC are detected in earlier stages.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ekbom A, Heimick C, Zack M, Adami HO (1990) Ulcerative colitis and colorectal cancer. A population based study. N Engl J Med 323:1228–1233
Van Staa TP, Card T, Logan RF, Logan RF, Leufkens HG (2005) 5-Aminosalicylate use and colorectal cancer risk in inflammatory bowel disease: a large epidemiological study. Gut 54:1573–1578
Baumgart DC, Sandborn WJ (2007) Inflammatory bowel disease: clinical aspects and established and evolving therapies. Lancet 369:1641–1657
Byers T, Levin B, Rothenberger DA, Dodd GD, Smith RA (1997) American cancer society guidelines for screening and surveillance for early detection of colorectal polyps and cancer: update 1997. American cancer society detection and treatment advisory group on colorectal cancer. CA Cancer J Clin 47:154–160
Watanabe T, Konishi T, Kishimoto J et al (2011) Ulcerative colitis-associated colorectal cancer shows a poorer survival than sporadic colorectal cancer: a nationwide Japanese study. Inflamm Bowel Dis 17:802–808
Truelove SC, Witts LJ (1995) Cortisone in ulcerative colitis: final report on a therapeutic trial. Br Med J 24947:1041–1048
Heimann TM, Greenstein AJ, Bolnick K, Yoelson S, Aufses AH (1985) Colorectal cancer in familial polyposis and ulcerative colitis. Dis Colon Rectum 28:658–661
Eaden JA, Abrams KR, Mayberry JF (2001) The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut 48:526–535
Pinczowski D, Ekbom A, Baron J, Yuen J, Adami HO (1994) Risk factors for colorectal cancer in patients with ulcerative colitis: a case–control study. Gastroenterology 107:117–120
Rutter M, Saunders B, Wilkinson K et al (2004) Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis. Gastroenterology 126:451–459
Rubin DT, Cruz-correa MR, Gasche C et al (2008) Colorectal cancer prevention in inflammatory bowel disease and the role of 5-aminosalicylic acid: a clinical review and update. Inflamm Bowel Dis 14:265–274
Velayos FS, Terdiman JP, Walsh JM (2005) Effect of 5-aminosalicylate use on colorectal cancer and dysplasia risk: a systematic review and metaanalysis of observational studies. Am J Gastroenterol 100:1345–1353
Chan EP, Lichtenstein GR (2006) Chemoprevention risk reduction with medical therapy of inflammatory bowel disease. Gastroenterol Clin North Am 35:675–712
Bernstein CN, Nugent Z, Blanchard JF (2011) 5-Aminosalicylate is not chemoprophylactic for colorectal cancer in IBD: a population based study. Am J Gastroenterol 106:731–736
Baars JE, Looman CW, Steyerberg EW et al (2011) The risk of inflammatory bowel disease-related colorectal carcinoma is limited result from a nationwide nested case–control study. Am J Gastroenterol 106:319–328
Actis GC, Pellicano R, David E, Sapino A (2010) Azathioprine, mucosal healing in ulcerative colitis, and the chemoprevention of colitic cancer: a clinical-practice-based forecast. Inflamm Allergy Drug Targets 9:6–9
Rubin DT (2006) The changing face of colorectal cancer in inflammatory bowel disease: progress at least! Gastroenterology 130:1350–1352
Chambers WM, Warren BF, Jewell DP, Mortensen NJ (2005) Cancer surveillance in ulcerative colitis. Br J Surg 92:928–936
Ohman U (1982) Colorectal carcinoma in patients with ulcerative colitis. Am J Surg 144:344–349
Jensen AB, Larsen M, Gislum M et al (2006) Survival after colorectal cancer in patients with ulcerative colitis: a nationwide population-based Danish study. Am J Gastroenterol 101:1283–1287
Lavery IC, Chiulli RA, Jagelman DG, Fazio VW, Weakley FL (1982) Survival with carcinoma arising in mucosal ulcerative colitis. Ann Surg 195:508–512
Sugita A, Greenstein AJ, Ribeiro MB et al (1993) Survival with colorectal cancer in ulcerative colitis. A study of 102 cases. Ann Surg 218:189–195
Conflicts of interest
None of the authors have any conflicts of interest associated with this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Matsuoka, H., Ikeuchi, H., Uchino, M. et al. Clinicopathological features of ulcerative colitis-associated colorectal cancer pointing to efficiency of surveillance colonoscopy in a large retrospective Japanese cohort. Int J Colorectal Dis 28, 829–834 (2013). https://doi.org/10.1007/s00384-012-1592-6
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00384-012-1592-6