TY - JOUR
T1 - Long-term risk of cancer in ulcerative colitis
T2 - a population-based cohort study from Copenhagen County
AU - Winther, Karen V
AU - Jess, Tine
AU - Langholz, Ebbe
AU - Munkholm, Pia
AU - Binder, Vibeke
PY - 2004/12
Y1 - 2004/12
N2 - BACKGROUND & AIMS: Ulcerative colitis (UC) is associated with an increased risk for colorectal cancer (CRC) and possibly also increased risk for cancers outside the intestinal tract. We followed-up a population-based cohort of 1160 patients with UC diagnosed in Copenhagen County between 1962 and 1987 for up to 36 years to analyze the overall and site-specific cancer risk.METHODS: Observed vs. expected cancers were presented as standardized morbidity ratio (SMR) with 95% exact confidence intervals (CI) calculated by using individual person-years at risk and sex- and age-specific incidence rates for the Danish background population in 1995.RESULTS: The cohort was followed-up for a median of 19 years, or 22,290 person-years. A total of 124 malignancies were observed compared with 139.85 expected (SMR, .89; 95% CI, .74-1.07). The observed number of CRCs was almost exactly equal to expected: 13 cases vs. 12.42 (SMR, 1.05; 95% CI, .56-1.79). The cumulative probability of CRC was .4% by 10 years, 1.1% by 20 years, and 2.1% by 30 years of disease. Among men, melanoma was increased (SMR, 3.45; 95% CI, 1.38-7.10); otherwise, no increased risk for cancer could be detected. No hepatobiliary cancers and no increased risk for lymphoma or leukemia were found.CONCLUSIONS: Neither the overall cancer risk, nor the CRC risk, were increased in this population-based cohort after a median of 19 years of follow-up evaluation. An active surgical approach in medical treatment failures and long-term use of 5-aminosalicylic acid (5-ASA) as relapse prevention may explain this remarkable result.
AB - BACKGROUND & AIMS: Ulcerative colitis (UC) is associated with an increased risk for colorectal cancer (CRC) and possibly also increased risk for cancers outside the intestinal tract. We followed-up a population-based cohort of 1160 patients with UC diagnosed in Copenhagen County between 1962 and 1987 for up to 36 years to analyze the overall and site-specific cancer risk.METHODS: Observed vs. expected cancers were presented as standardized morbidity ratio (SMR) with 95% exact confidence intervals (CI) calculated by using individual person-years at risk and sex- and age-specific incidence rates for the Danish background population in 1995.RESULTS: The cohort was followed-up for a median of 19 years, or 22,290 person-years. A total of 124 malignancies were observed compared with 139.85 expected (SMR, .89; 95% CI, .74-1.07). The observed number of CRCs was almost exactly equal to expected: 13 cases vs. 12.42 (SMR, 1.05; 95% CI, .56-1.79). The cumulative probability of CRC was .4% by 10 years, 1.1% by 20 years, and 2.1% by 30 years of disease. Among men, melanoma was increased (SMR, 3.45; 95% CI, 1.38-7.10); otherwise, no increased risk for cancer could be detected. No hepatobiliary cancers and no increased risk for lymphoma or leukemia were found.CONCLUSIONS: Neither the overall cancer risk, nor the CRC risk, were increased in this population-based cohort after a median of 19 years of follow-up evaluation. An active surgical approach in medical treatment failures and long-term use of 5-aminosalicylic acid (5-ASA) as relapse prevention may explain this remarkable result.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
KW - Azathioprine/therapeutic use
KW - Cohort Studies
KW - Colectomy
KW - Colitis, Ulcerative/epidemiology
KW - Denmark/epidemiology
KW - Female
KW - Humans
KW - Immunosuppressive Agents/therapeutic use
KW - Longitudinal Studies
KW - Male
KW - Mesalamine/therapeutic use
KW - Middle Aged
KW - Neoplasms/epidemiology
KW - Population Surveillance
KW - Registries
KW - Risk Assessment
M3 - Journal article
C2 - 15625654
SN - 1542-3565
VL - 2
SP - 1088
EP - 1095
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 12
ER -
