Colorectal cancer and high grade dysplasia complicating ulcerative colitis in Italy: A retrospective co-operative IG-IBD study

G. Riegler, F. Bossa, L. Caserta, A. Pera, F. Tonelli, G. C. Sturniolo, L. Oliva, E. Contessini Avesani, G. Poggioli

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background. Ulcerative colitis is a well-known risk factor for colorectal cancer. Aim. To take a census of the cases of colorectal cancer in ulcerative colitis patients observed in Italy and to evaluate the clinical presentation of neoplastic complication. Patients and methods. Experts from 28 Italian centres specialised in the management of inflammatory bowel disease or malignancies participated to the study. They were invited to send clinical data of patients with ulcerative colitis complicated by colorectal cancer or high-grade dysplasia consecutively observed between 1985 and 2000. One hundred and twelve patients (92 with cancer and 20 with high-grade dysplasia) were collected. Fourteen of them had undergone colectomy and ileo-rectal anastomosis for ulcerative colitis. Data of surgical patients were analysed separately. Results. The mean age at diagnosis of ulcerative colitis and colorectal cancer patients was 39.3 and 53.2 years, respectively, and the mean duration between diagnosis of ulcerative colitis and cancer was 13.9 years (range 0-53). Inflammation was proximal to the splenic flexure in 71 cases (76.3%). One hundred and three colorectal cancers were registered (93 patients with single lesion and five patients with two synchronous cancers), with 76.7% of cancers being located in the left colon. As to the surgical patients, the mean age at diagnosis of ulcerative colitis and cancer was 28.9 and 47.0 years, respectively, and the mean diagnostic interval for ulcerative colitis and cancer was 18.1 years. Only 51 out of 112 patients were in follow-up. An early diagnosis of neoplasia (high grade dysplasia, stage A or B sec. Dukes) occurred in 72.5% of patients who were subjected to endoscopic surveillance and in 48.0% of patients who did not undergo endoscopic surveillance (p=0.02). Conclusions. These data show an earlier diagnosis of cancer in patients who had undergone endoscopic surveillance. The poor compliance to the follow-up program, however, reduces its effectiveness. Moreover, total colectomy allows an easier follow-up, with only the rectum being controlled. Colectomy with ileo-rectal anastomosis or proctocolectomy with ileo-anal anastomosis, could represent a valid alternative in patients at high risk of cancer who refuse endoscopic surveillance.

Original languageEnglish
Pages (from-to)628-634
Number of pages7
JournalDigestive and Liver Disease
Volume35
Issue number9
DOIs
Publication statusPublished - Sep 2003

Fingerprint

Ulcerative Colitis
Italy
Colorectal Neoplasms
Neoplasms
Colectomy
Transverse Colon
Censuses
Inflammatory Bowel Diseases
Early Detection of Cancer
Rectum
Early Diagnosis
Colon

Keywords

  • Colorectal cancer
  • Endoscopic surveillance
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Colorectal cancer and high grade dysplasia complicating ulcerative colitis in Italy : A retrospective co-operative IG-IBD study. / Riegler, G.; Bossa, F.; Caserta, L.; Pera, A.; Tonelli, F.; Sturniolo, G. C.; Oliva, L.; Contessini Avesani, E.; Poggioli, G.

In: Digestive and Liver Disease, Vol. 35, No. 9, 09.2003, p. 628-634.

Research output: Contribution to journalArticle

Riegler, G, Bossa, F, Caserta, L, Pera, A, Tonelli, F, Sturniolo, GC, Oliva, L, Contessini Avesani, E & Poggioli, G 2003, 'Colorectal cancer and high grade dysplasia complicating ulcerative colitis in Italy: A retrospective co-operative IG-IBD study', Digestive and Liver Disease, vol. 35, no. 9, pp. 628-634. https://doi.org/10.1016/S1590-8658(03)00380-3
Riegler, G. ; Bossa, F. ; Caserta, L. ; Pera, A. ; Tonelli, F. ; Sturniolo, G. C. ; Oliva, L. ; Contessini Avesani, E. ; Poggioli, G. / Colorectal cancer and high grade dysplasia complicating ulcerative colitis in Italy : A retrospective co-operative IG-IBD study. In: Digestive and Liver Disease. 2003 ; Vol. 35, No. 9. pp. 628-634.
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abstract = "Background. Ulcerative colitis is a well-known risk factor for colorectal cancer. Aim. To take a census of the cases of colorectal cancer in ulcerative colitis patients observed in Italy and to evaluate the clinical presentation of neoplastic complication. Patients and methods. Experts from 28 Italian centres specialised in the management of inflammatory bowel disease or malignancies participated to the study. They were invited to send clinical data of patients with ulcerative colitis complicated by colorectal cancer or high-grade dysplasia consecutively observed between 1985 and 2000. One hundred and twelve patients (92 with cancer and 20 with high-grade dysplasia) were collected. Fourteen of them had undergone colectomy and ileo-rectal anastomosis for ulcerative colitis. Data of surgical patients were analysed separately. Results. The mean age at diagnosis of ulcerative colitis and colorectal cancer patients was 39.3 and 53.2 years, respectively, and the mean duration between diagnosis of ulcerative colitis and cancer was 13.9 years (range 0-53). Inflammation was proximal to the splenic flexure in 71 cases (76.3{\%}). One hundred and three colorectal cancers were registered (93 patients with single lesion and five patients with two synchronous cancers), with 76.7{\%} of cancers being located in the left colon. As to the surgical patients, the mean age at diagnosis of ulcerative colitis and cancer was 28.9 and 47.0 years, respectively, and the mean diagnostic interval for ulcerative colitis and cancer was 18.1 years. Only 51 out of 112 patients were in follow-up. An early diagnosis of neoplasia (high grade dysplasia, stage A or B sec. Dukes) occurred in 72.5{\%} of patients who were subjected to endoscopic surveillance and in 48.0{\%} of patients who did not undergo endoscopic surveillance (p=0.02). Conclusions. These data show an earlier diagnosis of cancer in patients who had undergone endoscopic surveillance. The poor compliance to the follow-up program, however, reduces its effectiveness. Moreover, total colectomy allows an easier follow-up, with only the rectum being controlled. Colectomy with ileo-rectal anastomosis or proctocolectomy with ileo-anal anastomosis, could represent a valid alternative in patients at high risk of cancer who refuse endoscopic surveillance.",
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T1 - Colorectal cancer and high grade dysplasia complicating ulcerative colitis in Italy

T2 - A retrospective co-operative IG-IBD study

AU - Riegler, G.

AU - Bossa, F.

AU - Caserta, L.

AU - Pera, A.

AU - Tonelli, F.

AU - Sturniolo, G. C.

AU - Oliva, L.

AU - Contessini Avesani, E.

AU - Poggioli, G.

PY - 2003/9

Y1 - 2003/9

N2 - Background. Ulcerative colitis is a well-known risk factor for colorectal cancer. Aim. To take a census of the cases of colorectal cancer in ulcerative colitis patients observed in Italy and to evaluate the clinical presentation of neoplastic complication. Patients and methods. Experts from 28 Italian centres specialised in the management of inflammatory bowel disease or malignancies participated to the study. They were invited to send clinical data of patients with ulcerative colitis complicated by colorectal cancer or high-grade dysplasia consecutively observed between 1985 and 2000. One hundred and twelve patients (92 with cancer and 20 with high-grade dysplasia) were collected. Fourteen of them had undergone colectomy and ileo-rectal anastomosis for ulcerative colitis. Data of surgical patients were analysed separately. Results. The mean age at diagnosis of ulcerative colitis and colorectal cancer patients was 39.3 and 53.2 years, respectively, and the mean duration between diagnosis of ulcerative colitis and cancer was 13.9 years (range 0-53). Inflammation was proximal to the splenic flexure in 71 cases (76.3%). One hundred and three colorectal cancers were registered (93 patients with single lesion and five patients with two synchronous cancers), with 76.7% of cancers being located in the left colon. As to the surgical patients, the mean age at diagnosis of ulcerative colitis and cancer was 28.9 and 47.0 years, respectively, and the mean diagnostic interval for ulcerative colitis and cancer was 18.1 years. Only 51 out of 112 patients were in follow-up. An early diagnosis of neoplasia (high grade dysplasia, stage A or B sec. Dukes) occurred in 72.5% of patients who were subjected to endoscopic surveillance and in 48.0% of patients who did not undergo endoscopic surveillance (p=0.02). Conclusions. These data show an earlier diagnosis of cancer in patients who had undergone endoscopic surveillance. The poor compliance to the follow-up program, however, reduces its effectiveness. Moreover, total colectomy allows an easier follow-up, with only the rectum being controlled. Colectomy with ileo-rectal anastomosis or proctocolectomy with ileo-anal anastomosis, could represent a valid alternative in patients at high risk of cancer who refuse endoscopic surveillance.

AB - Background. Ulcerative colitis is a well-known risk factor for colorectal cancer. Aim. To take a census of the cases of colorectal cancer in ulcerative colitis patients observed in Italy and to evaluate the clinical presentation of neoplastic complication. Patients and methods. Experts from 28 Italian centres specialised in the management of inflammatory bowel disease or malignancies participated to the study. They were invited to send clinical data of patients with ulcerative colitis complicated by colorectal cancer or high-grade dysplasia consecutively observed between 1985 and 2000. One hundred and twelve patients (92 with cancer and 20 with high-grade dysplasia) were collected. Fourteen of them had undergone colectomy and ileo-rectal anastomosis for ulcerative colitis. Data of surgical patients were analysed separately. Results. The mean age at diagnosis of ulcerative colitis and colorectal cancer patients was 39.3 and 53.2 years, respectively, and the mean duration between diagnosis of ulcerative colitis and cancer was 13.9 years (range 0-53). Inflammation was proximal to the splenic flexure in 71 cases (76.3%). One hundred and three colorectal cancers were registered (93 patients with single lesion and five patients with two synchronous cancers), with 76.7% of cancers being located in the left colon. As to the surgical patients, the mean age at diagnosis of ulcerative colitis and cancer was 28.9 and 47.0 years, respectively, and the mean diagnostic interval for ulcerative colitis and cancer was 18.1 years. Only 51 out of 112 patients were in follow-up. An early diagnosis of neoplasia (high grade dysplasia, stage A or B sec. Dukes) occurred in 72.5% of patients who were subjected to endoscopic surveillance and in 48.0% of patients who did not undergo endoscopic surveillance (p=0.02). Conclusions. These data show an earlier diagnosis of cancer in patients who had undergone endoscopic surveillance. The poor compliance to the follow-up program, however, reduces its effectiveness. Moreover, total colectomy allows an easier follow-up, with only the rectum being controlled. Colectomy with ileo-rectal anastomosis or proctocolectomy with ileo-anal anastomosis, could represent a valid alternative in patients at high risk of cancer who refuse endoscopic surveillance.

KW - Colorectal cancer

KW - Endoscopic surveillance

KW - Ulcerative colitis

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