Long-term risk of cancer in ulcerative colitis: a population-based cohort study from Copenhagen County

Karen V Winther; Tine Jess; Ebbe Langholz; Pia Munkholm; Vibeke Binder

Long-term risk of cancer in ulcerative colitis: a population-based cohort study from Copenhagen County

Karen V Winther, Tine Jess, Ebbe Langholz, Pia Munkholm, Vibeke Binder

Department of Clinical Medicine

232 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Clinical Gastroenterology and Hepatology
Volume	2
Issue number	12
Pages (from-to)	1088-95
Number of pages	8
ISSN	1542-3565
Publication status	Published - Dec 2004

Keywords

Adolescent
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
Azathioprine/therapeutic use
Cohort Studies
Colectomy
Colitis, Ulcerative/epidemiology
Denmark/epidemiology
Female
Humans
Immunosuppressive Agents/therapeutic use
Longitudinal Studies
Male
Mesalamine/therapeutic use
Middle Aged
Neoplasms/epidemiology
Population Surveillance
Registries
Risk Assessment

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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title = "Long-term risk of cancer in ulcerative colitis: a population-based cohort study from Copenhagen County",

abstract = "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.",

keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Azathioprine/therapeutic use, Cohort Studies, Colectomy, Colitis, Ulcerative/epidemiology, Denmark/epidemiology, Female, Humans, Immunosuppressive Agents/therapeutic use, Longitudinal Studies, Male, Mesalamine/therapeutic use, Middle Aged, Neoplasms/epidemiology, Population Surveillance, Registries, Risk Assessment",

author = "Winther, {Karen V} and Tine Jess and Ebbe Langholz and Pia Munkholm and Vibeke Binder",

year = "2004",

month = dec,

language = "English",

volume = "2",

pages = "1088--95",

journal = "Clinical Gastroenterology and Hepatology",

issn = "1542-3565",

publisher = "W.B.Saunders Co.",

number = "12",

}

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 -

Long-term risk of cancer in ulcerative colitis: a population-based cohort study from Copenhagen County

Abstract

Keywords

UN SDGs

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