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Comparative Study
. 2003 Oct 6;89(7):1232-6.
doi: 10.1038/sj.bjc.6601247.

Earlier surveillance colonoscopy programme improves survival in patients with ulcerative colitis associated colorectal cancer: results of a 23-year surveillance programme in the Japanese population

K Hata  1 , T Watanabe, S Kazama, K Suzuki, M Shinozaki, T Yokoyama, K Matsuda, T Muto, H Nagawa
Affiliations
Comparative Study

Earlier surveillance colonoscopy programme improves survival in patients with ulcerative colitis associated colorectal cancer: results of a 23-year surveillance programme in the Japanese population

K Hata et al. Br J Cancer. .

Abstract

Patients with long-standing ulcerative colitis (UC) are known to have an increased risk for the development of colorectal cancer (CRC). The aim of this study was to clarify the cumulative risk for the development of dysplasia or invasive cancer and the effectiveness of surveillance colonoscopy in the Japanese population. A total of 217 patients received a total of 1027 surveillance colonoscopies between January 1979 and December 2001 at the University of Tokyo hospital. Patients with invasive cancer found in the surveillance group were compared to those referred to our hospital from the other hospitals without surveillance colonoscopy. Surveillance colonoscopy confirmed 15 patients with definite dysplasia. Of these, five were proved to have invasive cancer in the resected specimens. The cumulative risk for the development of invasive cancer at 10, 20, and 30 years was 0.5, 4.1, and 6.1%, respectively, while that for the development of definite dysplasia at 10, 20, and 30 years was 3.1, 10.0, and 15.6%, respectively. All the patients with invasive cancer in the surveillance group remained alive, while three out of four patients in the nonsurveillance group died. Our surveillance programme is useful for detecting UC-associated CRC, and survival may be improved by surveillance colonoscopy.

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Figures

Figure 1
Figure 1
Summary of the results of a surveillance colonoscopy programme in the Japanese population (*the highest degree of dysplasia found in colonoscopy was used. CA=invasive cancer; HGD=high-grade dysplasia; LGD=low-grade dysplasia ; NEG=negative for dysplasia).
Figure 2
Figure 2
Results of surveillance colonoscopies in patients who were found to have high-grade dysplasia or invasive carcinoma in resected specimen.
Figure 3
Figure 3
The cumulative definite dysplasia- and cancer-free survival rates in patients with long-standing ulcerative colitis in the Japanese population.
See this image and copyright information in PMC

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