title: Crohn's disease over 20 years after diagnosis in a referral population.
abstract: OBJECTIVE
  Patients frequently ask questions about the lifetime prognosis of Crohn's disease. The aim of this study was to describe the outcomes of Crohn's disease more than 20 years after diagnosis.
  
  
  METHODS
  Data from all patients with Crohn's disease whose diagnosis had been performed before 1st January 1978 were analyzed. All referred patients filled in a medical and health-related quality-of-life questionnaire.
  
  
  RESULTS
  Among 273 patients with Crohn's disease diagnosed more than 20 years ago, 141 (52%) patients answered our questionnaire, 45 (16%) patients were alive but did not wish to answer our questionnaire, 51 (19%) could not be traced and 36 (13%) died before July 1998. At the end of follow-up, 25.7 (20.0-59.3) years after diagnosis, 24% had a relapse in the previous 12 months, and 48% and 28% had quiescent disease with and without treatment, respectively. These ratios were not different from those observed three years after Crohn's disease diagnosis. Sixteen patients died within 20 years after CD diagnosis, including 11 from CD-related causes. The risk of death estimated by Kaplan-Meier life-tables analysis was non-significantly higher if death was related to CD. An ileal or colic adenocarcinoma was noted in 6 (3.4%) patients.
  
  
  CONCLUSIONS
  Crohn's disease activity does not burn out with time, and roughly one-quarter of the patients had active disease 20 years after diagnosis.
authors.affiliation: Hépato-Gastroentérologie et Assistance Nutritive, Hôpital Lariboisière, Paris.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Etienney
authors.forename: Yoram
authors.initials: Y
authors.lastname: Bouhnik
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Gendre
authors.forename: Marc
authors.initials: M
authors.lastname: Lémann
authors.forename: Jacques
authors.initials: J
authors.lastname: Cosnes
authors.forename: Claude
authors.initials: C
authors.lastname: Matuchansky
authors.forename: Laurent
authors.initials: L
authors.lastname: Beaugerie
authors.forename: Robert
authors.initials: R
authors.lastname: Modigliani
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Rambaud
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000401:mortality* / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007414:Intestinal Neoplasms / Q000453:epidemiology; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D016331:Parenteral Nutrition, Home / Q000706:statistics & numerical data; D011788:Quality of Life; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D019804:Mesalamine; D001379:Azathioprine; D008727:Methotrexate