PMID- 16211714
OWN - NLM
STAT- MEDLINE
DCOM- 20051213
LR  - 20190814
IS  - 0036-5521 (Print)
IS  - 0036-5521 (Linking)
VI  - 40
IP  - 9
DP  - 2005 Sep
TI  - Efficiency of colorectal cancer surveillance in patients with ulcerative colitis: 
      26 years' experience in a patient cohort from a defined population area.
PG  - 1076-80
AB  - OBJECTIVE: Patients with ulcerative colitis (UC) have an increased risk of 
      developing colorectal cancer (CRC). The current procedure to diminish this risk 
      is colonoscopic surveillance and histopathological evaluation of biopsy 
      specimens. This method is not unquestioned and is undergoing continuous 
      evaluation. The present study is a major update of an earlier reported 
      investigation from an ongoing surveillance programme. MATERIAL AND METHODS: In 
      1977 a colonoscopic surveillance programme comprising all patients with UC from a 
      defined area was started in Ornskoldsvik. Three principal investigators performed 
      regular colonoscopy with mucosal sampling for histopathological evaluation. Some 
      211 patients were studied from 1977 to 2002. At the end of the study period, 90 
      patients, including those operated on, had total colitis (TC) for more than 10 
      years, 74 patients had left the study, 31 after panproctocolectomy (PPC), 6 owing 
      to advanced biological age, 1 because of intercurrent disease, 23 patients had 
      moved out of the area and 13 patients were excluded because of poor compliance. 
      In all, 928 colonoscopies were performed. RESULTS: It was found that 135 patients 
      had radiologically or morphologically defined TC and 69 patients had left-sided 
      colitis (LC). Nine CRCs were diagnosed in 8 patients, one of whom died of CRC, 
      while another two were included in the programme with a diagnosis of CRC. 
      Morphological alterations classified as dysplasia or indefinite for dysplasia 
      (ID) were found in 52 patients, 5 of whom were later found to have CRC. Eighteen 
      of the patients were operated on for different kinds of colonic resections and in 
      31 patients a PPC was performed. CONCLUSIONS: Colonoscopic surveillance is an 
      effective method in preventing death from CRC among patients with UC. A 
      conservative approach to surgery seems to be justified. The burden of the 
      surveillance programme has been acceptable. The outcome depends on good patient 
      compliance as well as the involvement of as few investigators as possible.
FAU - Lindberg, Jan
AU  - Lindberg J
AD  - Department of Surgery, Ornskoldsvik Hospital, Ornskoldsvik, and Department of 
      Medical Biosciences and Pathology, Umea University, Sweden. jan.lindberg@lvn.se
FAU - Stenling, Roger
AU  - Stenling R
FAU - Palmqvist, Richard
AU  - Palmqvist R
FAU - Rutegard, Jorgen
AU  - Rutegard J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Scand J Gastroenterol
JT  - Scandinavian journal of gastroenterology
JID - 0060105
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Child
MH  - Child, Preschool
MH  - Colitis, Ulcerative/*complications/pathology
MH  - Colonoscopy
MH  - Colorectal Neoplasms/*diagnosis/epidemiology/etiology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Intestinal Mucosa/pathology
MH  - Male
MH  - Middle Aged
MH  - *Population Surveillance
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Sweden/epidemiology
MH  - Time Factors
EDAT- 2005/10/08 09:00
MHDA- 2005/12/15 09:00
CRDT- 2005/10/08 09:00
PHST- 2005/10/08 09:00 [pubmed]
PHST- 2005/12/15 09:00 [medline]
PHST- 2005/10/08 09:00 [entrez]
AID - 10.1080/00365520510023224 [doi]
PST - ppublish
SO  - Scand J Gastroenterol. 2005 Sep;40(9):1076-80. doi: 10.1080/00365520510023224.