Surveillance in ulcerative colitis: burdens and benefit.

Abstract

SUMMARY A review of all patients with ulcerative colitis in one health district between 1975-84 revealed an incidence and prevalence of 7.1 and 84/100000 population respectively. One hundred and ninety five new patients were diagnosed and 313 patients seen and followed up in the clinic for 1168 patient years. None of these patients died from colitis or a complication. On routine colonoscopy three cases had high grade dysplasia and two asymptomatic carcinomas (Duke's stage A and B). Eighty four patients were known to have ulcerative colitis, but were lost to follow up from the hospital clinic; the total time they were not under hospital surveillance was 315 patient years. At the end of the study these patients were contacted or clinical details obtained from their general practitioners. Five of these patients subsequently presented with symptomatic carcinomas (two Duke's B, one Duke's C and two with metastases

The risk of colorectal cancer in ulcerative colitis: a meta-analysis

“… 1-150 References7 81 94-96 99 101-108 110 113-117 120-122 124 127 128 132 133 135-138 140 142 143 145 148 150 155 157 159 161 163 165 167 170-173 176 177 180–182 185–189 191–205 1-151 References93 98 100 109 112 123 126 134 141 146 147 149 151-154 158 160 162 166 168 169 175 ‡ References10 97 111 118 119 125 129-131 139 144 156 164 174 178 179 183 184 190 …”

Dysplasia in ulcerative colitis?clinical consequences?

“…In many of the hitherto reported surveillance programmes, the technical feasibility of the concept has, indeed, been proven [23,25,29,30,31], and, moreover, non-randomized studies have indicated that surveyed UC patients have much less risk of dying from CRC than do non-surveyed patients [30,32].…”

“…It has been estimated that approximately 33 biopsies are necessary to allow 90% confidence of detecting focal dysplasia [40]. Even so, the experience from several prospective colonoscopic programmes shows that biopsies taken from six to ten different sites throughout the colon and rectum are sufficient for dysplasia to be detected, and, thereby, the risk of an incurable CRC's being missed is low [22,23,25,29,30,31,32].…”

Medical management of ulcerative colitis

“…Its incidence in Europe is estimated to be 5-25 new patients per 100,000 inhabitants per year [1][2][3][4][5] . As its course and extent vary considerably, an individualized diagnostic approach and therapy are mandatory.…”