Colorectal cancer in ulcerative colitis patients: survival curves and surveillance. 1994

B A Lashner
Department of Gastroenterology, Cleveland Clinic Foundation, OH 44195.

BACKGROUND Survival curves can provide useful information for designing cancer surveillance programs. OBJECTIVE To outline how to derive the density and hazard functions from the survival curve and to use this information to make recommendations regarding cancer surveillance in patients with ulcerative colitis. CONCLUSIONS The hazard of cancer or dysplasia remains low during the first decade of ulcerative colitis but rises exponentially thereafter. After 40 years, approximately 20% of patients with ulcerative colitis acquire cancer or dysplasia per year. CONCLUSIONS A reasonable recommendation for cancer surveillance based on information from survival curves would be a colonoscopy with biopsy approximately 10 years after the onset of ulcerative colitis, and repeated every 3 years for the next decade, every 2 years for the subsequent decade, and every year thereafter. Prophylactic proctocolectomy is an option after 40 years of disease due to the extremely high cancer risk, but data supporting this option are sparse.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
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
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011230 Precancerous Conditions Pathological conditions that tend eventually to become malignant. Preneoplastic Conditions,Condition, Preneoplastic,Conditions, Preneoplastic,Preneoplastic Condition,Condition, Precancerous,Conditions, Precancerous,Precancerous Condition
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
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
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths

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