Colorectal cancer in patients with ulcerative colitis

Gilat, Tuvia; Fireman, Zvi; Grossman, Alon; Hacohen, Dalia; Kadish, U; Ron, Elaine; Rozen, Paul; Lilos, Pearl

doi:10.1016/0016-5085(88)90541-0

Cited by 183 publications

(65 citation statements)

References 12 publications

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“…Beginning only 10 years after the onset of ulcerative colitis, the cumulative risk of colorectal cancer has been reported to reach 30% over the next 30 years, that is, 40 years after the first diagnosis of the disease. [4][5][6][7] Under baseline assumptions, the cost-benefit analysis yields a threshold of 27%. Varying individual probability values and cost estimates can raise the threshold far above or lower it far below the true cumulative cancer risk.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] The time dependent increase in the occurrence of colorectal cancer corresponds to the transition probability p for the development of cancer per one cycle length. It is calculated as the diVerence between two values of equation (1) at two consecutive time points one cycle length apart: p = %CRC 2 − %CRC 1 = e k.time (e k.cycle − 100%)(2) From long term follow up data, Lashner et al have estimated an average time lag of three years between the first occurrence of dysplasia and the subsequent development of cancer.…”

Section: Transition Probabilitiesmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] After 40 years about 30% of all patients with pancolitis have developed colorectal cancer, [4][5][6][7] compared with a 6% cumulative risk over lifetime for such cancer in the general population. 8 Because of the increased risk of cancer, surveillance colonoscopy in long standing pancolitis has been widely recommended.…”

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confidence: 99%

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Decision analysis of surveillance for colorectal cancer in ulcerative colitis

Delcò

Sonnenberg²

2000

Gastroenterology

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Background-Patients with long standing, extensive ulcerative colitis have an increased risk of developing colorectal cancer. Aims-To assess the feasibility of surveillance colonoscopy in preventing death from colorectal cancer. Patients-A hypothetical cohort of patients with chronic ulcerative colitis. Methods-The benefits of life years saved were weighted against the costs of biannual colonoscopy and proctocolectomy, and the terminal care of patients dying from colorectal cancer. Two separate Markov processes were modelled to compare the cost-benefit relation in patients with or without surveillance. The cumulative probability of developing colorectal cancer served as a threshold to determine which of the two management strategies is associated with a larger net benefit. Results-If the cumulative probability of colorectal cancer exceeds a threshold value of 27%, surveillance becomes more beneficial than no surveillance. The threshold is only slightly smaller than the actual cumulative cancer rate of 30%. Variations of the assumptions built into the model can raise the threshold above or lower it far below the actual rate. If several of the assumptions are varied jointly, even small changes can lead to extreme threshold values. Conclusions-It is not possible to prove that frequent colonoscopies scheduled at regular intervals are an eVective means to manage the increased risk of colorectal cancer associated with ulcerative colitis. (Gut 2000;46:500-506)

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Section: Discussionmentioning

confidence: 99%

Section: Transition Probabilitiesmentioning

confidence: 99%

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Decision analysis of surveillance for colorectal cancer in ulcerative colitis

Delcò

Sonnenberg²

2000

Gastroenterology

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“…Furthermore, colectomy rates were relatively high in this cohort (15-year colectomy rates of 20 and 15% in CD and UC, respectively) [2, 12]. Other factors, such as diet and genetic predisposition, may also play an important role in the observed different incidence rates because lower than expected CRC risk has been described in other population-based cohorts [13]. …”

Section: Magnitude Of Crc Riskmentioning

confidence: 99%

Prevention of Colorectal Cancer in Inflammatory Bowel Disease: Value of Screening and 5-Aminosalicylates

et al. 2006

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Colorectal cancer is a serious complication of inflammatory bowel disease. Given this fact, it is necessary to examine the opportunities for current and future approaches to colorectal cancer prevention. The value of surveillance colonoscopy and chemoprevention of colorectal cancer with 5′-aminosalicylic acid has been evaluated in the recent literature. The current state of knowledge in the epidemiology of and new approaches to the prevention of cancer and dysplasia in inflammatory bowel disease were reviewed. It is concluded that there is significant preclinical and clinical evidence to suggest that 5-aminosalicylate drugs reduce the risk of colorectal neoplasia. However, the minimal dosage to achieve this chemopreventive effect remains unclear. There is also indirect evidence to suggest that surveillance colonoscopy is beneficial for patients with inflammatory bowel disease, particularly in those with long-standing pancolitis or primary sclerosing cholangitis-associated inflammatory bowel disease. However, definitive proof from prospective clinical trials is not available.

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“…Reported relative risks for colorectal cancer in patients with UC compared to the general population vary between 1 and 20 [1][2][3][4][5], as recently reviewed by Choi and Kim [6]. The variability in results is likely due to differences in study design and patient populations, including the type of study (population or referral-center based), geographic location, length of follow-up, extent of UC at the time of diagnosis, ages of patients at diagnosis, and frequency of colectomy in the study population.…”

Section: Epidemiology Of Cancer Risk In Ulcerative Colitismentioning

confidence: 99%

Ulcerative Colitis and Colon Cancer: More Controversy than Clarity

Snapper

Syngal²

1998

Dig Dis

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Although it is generally accepted that the risk of colorectal cancer in patients with ulcerative colitis is increased compared with the general population, the management of this increased risk remains controversial. Patients with pancolitis of > 8 years duration should consider periodic colonoscopic surveillance or prophylactic colectomy. For patients unwilling to undergo prophylactic colectomy, colonoscopic surveillance annually or biennially is recommended. High-grade dysplasia or low-grade dysplasia in association with a lesion or mass is an indication for colectomy when confirmed by 2 pathologists. Repeat colonoscopic surveillance (in 3–6 months) or colectomy is recommended for confirmed low-grade dysplasia.

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Colorectal cancer in patients with ulcerative colitis

Cited by 183 publications

References 12 publications

Decision analysis of surveillance for colorectal cancer in ulcerative colitis

Decision analysis of surveillance for colorectal cancer in ulcerative colitis

Prevention of Colorectal Cancer in Inflammatory Bowel Disease: Value of Screening and 5-Aminosalicylates

Ulcerative Colitis and Colon Cancer: More Controversy than Clarity

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