Colonoscopic surveillance in ulcerative colitis--dysplasia through the looking glass.

作者：J. B. J. Fozard, Michael F. Dixon · 发表于：Gut · 年份：1989 · DOI：10.1136/gut.30.3.285 · 被引用次数：23 · 研究领域：Inflammatory Bowel Disease、Microscopic Colitis、Genetic factors in colorectal cancer

Leading articleColonoscopic surveillance in ulcerative colitisdysplasia through the looking glass Reflection Carcinoma was first described as a complication of ulcerative colitis (UC) by Crohn and Rosenberg in 1925.' Since then many workers have attempted to quantify the degree of increased cancer risk associated with UC.Most early studies tended to overestimate the degree of risk, calculating cumulative cancer rates ranging from 16% to 43% depending on the duration of disease.2'In contrast, Hendricksen (in Denmark)' and Maratka (Czechoslovakia)6 have produced figures for cumulative risk of 1*4% and 5% at 18 and 20 years from onset respectively.The reasons for such wide discrepancies in the assessment of cancer risk have been well reviewed by Whelan7 and Lennard-Jones.iThey relate to inadequate follow up, differ- ences in study populations, treatment policy and methods of analysis.More recently, in a retrospective cohort study which took these criticisms into account, Gyde et al' report cumulative risks for cancer in extensive colitis of 7.2% at 20 years and 16-5% at 30 years, while in a population based study in Israel, Gilat et al'°found an incidence of 9.3% and 13.8% at 15 and 20 years respectively for total colitis.Based on such studies two factors have emerged as being of major importance in determining cancer risk, duration and extent of disease.There is a low risk of cancer at less than 10 years duration with increasing risk thereafter.There is a much greater cancer ri...