Colorectal cancer in patients with ulcerative colitis: A prospective cohort study in Italy

G. Biasco, G. Brandi, G. M. Paganelli, F. P. Rossini, R. Santucci, G. Di Febo, M. Miglioli, M. Risio, A. M M Labate, L. Barbara

Research output: Contribution to journalArticle

Abstract

Background. The aim of this study was to assess the development of dysplasia or cancer in patients with ulcerative colitis and to determine the effectiveness of colonoscopy and biopsy follow-up in colon cancer surveillance. Methods. From 1980 to 1986, 65 patients who had ulcerative colitis for 7 years or more participated in a surveillance program of colonoscopy and biopsy. This cohort was followed until December 1992. Forty- nine patients (75.4%) had extensive colitis and 16 (24.6%) left-sided colitis. The mean disease duration was 17.2 years. Three hundred four colonoscopies were performed. During each endoscopy, random biopsies were performed. Results. Seven patients had definite dysplasia of the colorectal mucosa. Four of them had high grade lesions and underwent surgery. In all of these patients, colon cancer (3 Dukes' Stage A, 1 Dukes' Stage B) was found. No cancer was found in the other patients. Pedunculated adenomas were excised from 6 other patients during colonoscopy. When dysplasia was diagnosed, these patients were older than those who were dysplasia free, whereas the age at onset of colitis was significantly higher in the former (P <0.01). Fifteen patients discontinued follow-up. Two of them developed colon cancer diagnosed at an advanced stage. Conclusions. Dysplasia, especially of high grade, is a marker of colon cancer risk in patients with longstanding ulcerative colitis. Intensive colonoscopy and biopsy surveillance can lead to the diagnosis of colon cancer at a potentially curable stage. In this series, older age appeared to be an additional risk factor. A careful selection of patients with ulcerative colitis seems mandatory to minimize the cost and optimize the benefit of colon cancer surveillance programs.

Original languageEnglish
Pages (from-to)2045-2050
Number of pages6
JournalCancer
Volume75
Issue number8
DOIs
Publication statusPublished - 1995

Keywords

  • biopsy
  • colonoscopy
  • colorectal cancer
  • dysplasia
  • ulcerative colitis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Biasco, G., Brandi, G., Paganelli, G. M., Rossini, F. P., Santucci, R., Di Febo, G., Miglioli, M., Risio, M., Labate, A. M. M., & Barbara, L. (1995). Colorectal cancer in patients with ulcerative colitis: A prospective cohort study in Italy. Cancer, 75(8), 2045-2050. https://doi.org/10.1002/1097-0142(19950415)75:8<2045::AID-CNCR2820750803>3.0.CO;2-X