Colon cancer surveillance in chronic ulcerative colitis: historical cohort study. 1990

B A Lashner, and S V Kane, and S B Hanauer
Section of Gastroenterology, University of Chicago Medical Center, Illinois.

Screening for dysplasia in ulcerative colitis is expected to improve cancer-related survival by advancing the diagnosis of cancer to a more favorable pathologic stage or by identifying patients for prophylactic colectomy who are at at high risk of developing cancer. To evaluate the effectiveness of a surveillance program of annual colonoscopy and mucosal sampling, 91 screened and 95 control ulcerative colitis patients with extensive disease for at least 8 yr were compared for differences in survival, cancer detection, and colectomy rates. The two groups were of similar age at symptom onset, duration of disease, and sex. In the surveillance group, there were eight fewer deaths (p less than 0.05 by survival-curve analysis), but two more cancer deaths (not significant). Colectomy was less common (p less than 0.05) and was performed 4 yr later in the surveillance group. The effect of surveillance was not confounded by age at symptom onset, sex, or duration of disease. In our program, screening for cancer in ulcerative colitis was associated with improved survival and delayed colectomy. However, improvement was not related to the anticipated benefits of improved cancer-related survival.

UI MeSH Term Description Entries
D007413 Intestinal Mucosa Lining of the INTESTINES, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. In the SMALL INTESTINE, the mucosa is characterized by a series of folds and abundance of absorptive cells (ENTEROCYTES) with MICROVILLI. Intestinal Epithelium,Intestinal Glands,Epithelium, Intestinal,Gland, Intestinal,Glands, Intestinal,Intestinal Gland,Mucosa, Intestinal
D008297 Male Males
D008403 Mass Screening Organized periodic procedures performed on large groups of people for the purpose of detecting disease. Screening,Mass Screenings,Screening, Mass,Screenings,Screenings, Mass
D011159 Population Surveillance Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy. Surveillance, Population
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D003082 Colectomy Surgical resection of a portion of or the entire colon. Hemicolectomy,Large Bowel Resection,Colectomies,Hemicolectomies,Large Bowel Resections,Resection, Large Bowel,Resections, Large Bowel
D003093 Colitis, Ulcerative Inflammation of the COLON that is predominantly confined to the MUCOSA. Its major symptoms include DIARRHEA, rectal BLEEDING, the passage of MUCUS, and ABDOMINAL PAIN. Colitis Gravis,Idiopathic Proctocolitis,Inflammatory Bowel Disease, Ulcerative Colitis Type,Ulcerative Colitis
D003110 Colonic Neoplasms Tumors or cancer of the COLON. Cancer of Colon,Colon Adenocarcinoma,Colon Cancer,Cancer of the Colon,Colon Neoplasms,Colonic Cancer,Neoplasms, Colonic,Adenocarcinoma, Colon,Adenocarcinomas, Colon,Cancer, Colon,Cancer, Colonic,Cancers, Colon,Cancers, Colonic,Colon Adenocarcinomas,Colon Cancers,Colon Neoplasm,Colonic Cancers,Colonic Neoplasm,Neoplasm, Colon,Neoplasm, Colonic,Neoplasms, Colon
D003113 Colonoscopy Endoscopic examination, therapy or surgery of the luminal surface of the colon. Colonoscopic Surgical Procedures,Surgical Procedures, Colonoscopic,Colonoscopic Surgery,Surgery, Colonoscopic,Colonoscopic Surgeries,Colonoscopic Surgical Procedure,Colonoscopies,Procedure, Colonoscopic Surgical,Procedures, Colonoscopic Surgical,Surgeries, Colonoscopic,Surgical Procedure, Colonoscopic
D005260 Female Females

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