Cancer in Ulcerative Colitis

Slaney, G; Brooke, Bryan N.

doi:10.1016/s0140-6736(59)92130-0

Cited by 124 publications

(33 citation statements)

References 24 publications

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“…The exact incidence of malignant change varies, usually ranging from 1o% to 14% (Edwards and Truelove, 1964), whereas in the population at large the incidence is 0.06 % (Weckesser and Chinn, 1953). It is also accepted that the likelihood of developing a carcinoma increases with the duration of the colitis (Lagercrantz, 1955;Rosenqvist, Lagercrantz, Ohrling, and Edling, 1959;Slaney and Brooke, 1959), reaching definite clinical significance after 10 years (Hinton, 1966) and rising to an incidence of 56% after 30 years (de Dombal, Watts, Watkinson, and Goligher, 1966). These patients develop carcinoma at an unusually early age (Shands, Dockerty, and Bargen, 1952;Rosenqvist et al, 1959;Slaney and Brooke, 1959;Hodgson and Sauer, 1961;Edwards and Truelove, 1964).…”

Section: Discussionmentioning

confidence: 99%

Radiological findings in carcinoma of the colon complicating chronic ulcerative colitis.

Fennessy¹,

Sparberg²,

Kirsner³

1968

Gut

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Section: Discussionmentioning

confidence: 99%

Radiological findings in carcinoma of the colon complicating chronic ulcerative colitis.

Fennessy¹,

Sparberg²,

Kirsner³

1968

Gut

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“…1 of colorectal cancer over time, although only a few2 4-7 have compared the risk in the series with that in a relevant general population. Despite these reports, the magnitude and the pattern of risk is uncertain and varies from one reported series to another.…”

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confidence: 99%

Cancer morbidity in ulcerative colitis.

Prior¹,

Gyde²,

Macartney³

et al. 1982

Gut

166

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SUMMARY Cancer morbidity at all sites has been studied in a series of 676 patients with ulcerative colitis under long-term review, of whom more than two-thirds had extensive disease, and the level and pattern of risk over time examined. Age-, sex-, and site-specific incidence rates were used to compute the number of cancers that might have been expected to occur. A highly significant excess of cancers was observed overall but the excess was due entirely to cancers of the digestive system. In women there was no excess or deficit of cancers outside the digestive system. In men there was a small deficit of cancers of the respiratory system. An overall 11-fold excess colorectal cancer risk was found in the series compared with that in a relevant general population after patient-years at risk had been corrected for surgical resection and patients with colorectal cancer at their first referral had been excluded. When these data were expressed in an actuarial form the cumulative probability of developing colorectal cancer in the series was 8% (3.5-13%) at 25 years, after the diagnosis of ulcerative colitis had been established. The relative risk of developing colorectal cancer was highest in those patients developing colitis before the age of 30 years, and the relative risk fell as the age at diagnosis of their colitis increased. The pattern of risk of colorectal cancer over time suggests that there is an association between cancer and colitis in susceptible individuals and that the level of risk is related to age at onset of colitis.Previous studies of the cancer risk in ulcerative colitis 1-8 have been confined almost exclusively to colorectal cancer, with the exception of the hepatobiliary system, which has received some attention.10 There is little information about the cancer incidence at other sites. We have therefore studied the whole spectrum of cancer morbidity in a series of patients with ulcerative colitis. This enabled us to examine some aspects of patient selection (analysis of clinical series being subject to many elements of bias3) to provide a basis from which to approach the specific problem of colorectal cancer.Estimates of the incidence of colorectal cancer complicating ulcerative colitis in the early literature were based on crude percentages. 1 Actuarial methods are now used which take into account the decreasing numbers of patients at risk for cancer over extended periods of observation. of colorectal cancer over time, although only a few2 4-7 have compared the risk in the series with that in a relevant general population. Despite these reports, the magnitude and the pattern of risk is uncertain and varies from one reported series to another. These variations probably reflect differences in the composition of the reported series and in the methods used to evaluate the risk rather than real differences in the underlying cancer risk. The differing approaches to analysis have been discussed both in general3 611 and in individual series.7We have attempted to identify and, where possible, to correct fo...

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“…When large numbers of colitics with disease of varying extent and widely different duration of symptoms are considered the development of cancer is uncommon. In three big series the incidence lay between 3 and 4 % (Slaney and Brooke;1959, Nefzger andAcheson, 1963;Edwards and Truelove, 1964). It has been calculated by comparing death rates that in large series the cancer incidence is between seven and eleven times that to be expected in a matched general population (Goldgraber, Humphreys, Kirsner, and Palmer, 1958;de Dombal, Watts, Watkinson, and Goligher, 1966).…”

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confidence: 99%