Risk factors for developing colorectal cancer in Japanese patients with ulcerative colitis: a retrospective observational study—CAPITAL (Cohort and Practice for IBD total management in Kyoto-Shiga Links) study I

Abstract

Background and AimsPatients with ulcerative colitis (UC) are at risk for developing colorectal cancer (CRC), despite the development of new therapeutic agents. Stratification of the individual UC-patient's risk would be helpful to validate the risk factors for CRC. The aim of this study was to evaluate the risk factors for the development of CRC in a large cohort of patients with UC.MethodsData were obtained from 12 hospitals in the Kyoto-Shiga region during 2003–2013. We performed a retrospective cohort study of 2137 patients with UC.ResultsIn total, 60 lesions of CRC were detected in 43 (2.0%) of 2137 patients. 30 of the 43 patients were male. The median age was 53 years. The median duration of disease was 13 years, and 67.4% of these patients had a disease duration >10 years. Of the 43 patients, 34 (79.1%) had extensive colitis. Primary sclerosing cholangitis was detected in 2 patients (4.7%). The median corticosteroids (CS) dose was 6.4 g, and 4 patients were treated with a total of more than 10 g of CS. 18 of these patients underwent more than 1 year CS treatment. Of all 60 CRC lesions, 43 (71.7%) were located in the distal colon and 35 (58.3%) were of the superficial type. Moreover, the stage of CRC was stage 0 or I in 55.8% of the 43 patients with CRC. Multivariate analysis suggested that extensive colitis could be a risk factor for the development of advanced CRC in patients with UC.ConclusionsOur findings indicated that male, extensive colitis, long-term duration of UC and family history of CRC, but not concomitant primary sclerosing cholangitis, are important factors for predicting CRC in Japanese patients with UC. Moreover, long-standing extensive colitis might contribute to the progression of CRC. Further studies are required to establish CRC surveillance in Japanese patients with UC.

Osteopontin Deficiency Suppresses Intestinal Tumor Development in Apc-Deficient Min Mice

“…OPN depletion decreases inflammation and gastric epithelial proliferation during Helicobacter pylori infection in mice [ 69 ], and suppresses MNU and Helicobacter pylori -induced gastric cancer development [ 29 ]. As for colorectal cancer, inflammatory bowel diseases (IBDs), including ulcerative colitis (UC) and Crohn’s disease (CD), are well-known risk factors [ 70 , 71 , 72 ]. Increased levels of circulating and colonic tissue OPN in human IBD and experimentally-induced colitis in mice have been observed [ 73 , 74 , 75 , 76 , 77 , 78 ].…”

Progress of Integrated Traditional Chinese and Western Medicine Treatment in Ulcerative Colitis

“…In the 1960s, ulcerative colitis and CD were clearly differentiated by the British scientist Morson, and ulcerative colitis was classified as an independent disease [33]. Epidemiological statistics are shown [3] The incidence of UC in northern Europe and North America has always been steadily high in the world, but the current trend has been stable and even declining. The incidence of UC in developing countries such as South America and Southeast Asia is lower compared with developed countries, but the incidence gradually increases in recent years, and the incidence of UC in Taiwan is increasing steadily by 4.8% every year.…”

“…At present, the clinical treatment has a long treatment cycle, and it is difficult to induce and maintain remission. It is also found that it has a corresponding connection with colorectal cancer [2][3][4][5]. The incidence of ulcerative colitis has reached a plateau in developed countries in Europe and the United States and is increasing in new industrialized countries [6].…”

Colon Cancer: Intelligent Modeling of Risk Factors

“…inflammation. When colitis settles over time, it can be an aggravating factor in the development of colorectal cancer [3]. There is no doubt that the risk of colorectal cancer is directly associated with family ties, it is also demonstrated in families of patients with colorectal cancers Several factors may be the cause of colorectal cancer, however, demographic factors (implying genetic factors) and dietary factors largely explain mortality by this cancer, although this remains poorly explained [4], and family history or a personal history of ovarian, endometrial or breast cancer.…”