European evidence-based Consensus on the management of ulcerative colitis: Special situations

Biancone, Livia; Michetti, Pierre; Travis, Simon; Escher, Johanna C.; Moser, Gabriele; Forbes, Alastair; Hoffmann, Joerg; Dignaß, Axel; Gionchetti, Paolo; Jantschek, Günter; Kießlich, Ralf; Kolaček, Sanja; Mitchell, Rod; Panés, Julián; Söderholm, Johan D.; Vucelić, Boris; Stange, Eduard F.

doi:10.1016/j.crohns.2007.12.001

Cited by 215 publications

(159 citation statements)

References 297 publications

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“…Surveillance colonoscopy may permit earlier detection of CRC, with a correspondingly improved prognosis; however, unequivocal evidence is lacking that surveillance colonoscopy prolongs survival in patients with UC. Based on previous epidemiological data, international guidelines of the Crohn's and Colitis Foundation of America (CCFA) [24] and very recently the European Crohn's and Colitis Organisation (ECCO) [61] suggest a relatively strict surveillance policy. Whether these recommendations require adjustments in light of new epidemiological data that suggest a much lower CRC incidence remains questionable.…”

Section: Endoscopic Surveillance In Ibdmentioning

confidence: 99%

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Lakatos¹,

Lakatos²

2008

WJG

368

245

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Since the first report of an inflammatory bowel disease (IBD) case associated with colorectal cancer (CRC) by Crohn and Rosenberg [1] , significant efforts have been made to elucidate this presumed association. Nowadays, the association between IBD and the increased risk for CRC is widely accepted. Although CRC, complicating ulcerative colitis and Crohn's disease, accounts only for 1%-2% of all cases of CRC in the general population, it is considered a serious complication of the disease and accounts for approximately 10%-15% of all deaths in IBD patients [2] . The age at diagnosis of CRC associated with IBD is 15-20 years earlier compared to sporadic cancers. In the meta-analysis by Eaden et al [3] , the average age at diagnosis was 43.2 years. Similarly, in a recent publication from Eastern Europe [4] , it was found to be 50.9 years, 10-15 years younger compared to sporadic CRC cases from the same area (62.2 years) [5] . According to US [6] and Canadian [7] publications, almost two-thirds of the affected patients were males, yet results are conflicting [4,8] . In addition, the frequency of multiple CRCs is higher than in patients with sporadic CRC [9] .The increased risk of CRC in UC is almost a universal finding [3,[10][11][12][13] , yet the extent of this risk varies considerably with differences in study design and geographic area. The initial reports were published by tertiary gastroenterology centers, thus the high risk detected might have been a consequence of referral bias and overinterpretation due to the high percentage of extensive and chronically active cases in these cohorts. Results of population-based studies are more reliable; however, several geographical and ethnic differences have been noted.The report of the meta-analysis by Eaden et al [3] in 2001 was one of several milestones in this subject. The incidence of UC-associated CRC was estimated based on 116 articles involving 54 478 patients in whom 1698 CRC cases were detected. This was a mixture of referral center-based, hospital-based, and population-based studies of variable methodological qualities and levels of detail. The reported incidence was higher in the US AbstractThe risk of colorectal cancer for any patient with ulcerative colitis is known to be elevated, and is estimated to be 2% after 10 years, 8% after 20 years and 18% after 30 years of disease. Risk factors for cancer include extent and duration of ulcerative colitis, primary sclerosing cholangitis, a family history of sporadic colorectal cancer, severity of histologic bowel inflammation, and in some studies, young age at onset of colitis. In this review, the authors discuss recent epidemiological trends and causes for the observed changes. Population-based studies published within the past 5 years suggest that this risk has decreased over time, despite the low frequency of colectomies. The crude annual incidence rate of colorectal cancer in ulcerative colitis ranges from approximately 0.06% to 0.16% with a relative risk of 1.0-2.75. The exact mechanism for this chang...

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Section: Endoscopic Surveillance In Ibdmentioning

confidence: 99%

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Lakatos¹,

Lakatos²

2008

WJG

368

245

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show abstract

“…A surveillance program that includes a colonoscopic examination is the best approach currently available to prevent the development of CRC in both the general population and IBD patients [4][5][6][7][8]44,45] . There are several guidelines for recommending a specific surveillance program in IBD patients; these guidelines present some similarities along with various distinctions.…”

Section: Endoscopic Screeningmentioning

confidence: 99%

“…Several risk factors have been clearly identified, including an earlier onset of IBD, longer duration of colitis, and more extensive disease, along with others that have not been universally confirmed [3] . While the commonly accepted hypothesis of an increased risk of CRC in IBD patients has prompted medical society guidelines to endorse cancer prevention strategies [4][5][6][7][8] , current recommendations are still far from perfect and tend to miss a significant number of smaller mucosal lesions. In addition, because current surveillance programs in IBD patients imply repeated colonoscopies and multiple biopsies, they are both laborious and time-consuming.…”

Section: Introductionmentioning

confidence: 99%

Colorectal cancer surveillance in patients with inflammatory bowel disease: What ¡s new?

Guagnozzi

Lucendo²

2012

WJGE

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“…In the guidelines published by ECCO (European Crohn's and Colitis Organisation) in 2008 for UC, there were no recommendations about "Pregnancy and Lactation", which should be under the topic of special situations, and it was stated that these recommendations would be published later (5).…”

Section: Introductionmentioning

confidence: 99%

Safety of drugs used in cases with ulcerative colitis during pregnancy and lactation

Kalkan¹,

Dağlı²

2012

Turk J Gastroenterol

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European evidence-based Consensus on the management of ulcerative colitis: Special situations

Cited by 215 publications

References 297 publications

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Colorectal cancer surveillance in patients with inflammatory bowel disease: What ¡s new?

Safety of drugs used in cases with ulcerative colitis during pregnancy and lactation

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