Risk factors for ulcerative colitis-associated colorectal cancer in a Hungarian cohort of patients with ulcerative colitis: results of a population-based study.
BACKGROUND
There is an increased risk of colorectal cancer (CRC) in ulcerative colitis (UC). The prevalence of UC-associated CRC is different in various geographic regions. The risk depends primarily on the duration and extent of disease. The aim of this study was to identify the risk factors for and the epidemiology of CRC in Hungarian patients with UC.


METHODS
We retrospectively evaluated the relevant epidemiological and clinical data of all patients with UC in Veszprem province in our 30-year IBD database (723 patients with UC; male/female, 380/343; non-CRC related colectomies, 3.7%).


RESULTS
CRC was diagnosed in 13 patients (13/8564 person-year duration) during follow-up. Age at diagnosis of CRC was at a median of 51 (range 27-70) years. Eight patients are still alive, 4 died of CRC, and 1 died of an unrelated cause. Longer disease duration, extensive colitis, primary sclerosing cholangitis, and dysplasia found in the biopsy specimen were identified as risk factors for developing CRC. The cumulative risk of developing CRC after a disease duration of 10 years was 0.6% (95% confidence interval [CI] 0.2%-1.0%); 20 years, 5.4% (95% CI 3.7%-7.1%); and 30 years, 7.5% (95% CI 4.8%-10.2%). CRC diagnosed at surveillance colonoscopy was associated with a tendency for longer survival (P = 0.08).


CONCLUSIONS
The cumulative risk of CRC was high in our patients with UC; however, it was lower compared with that reported in Western European and North American studies. CRC developed approximately 15 years earlier compared with sporadic CRC patients in Hungary. Longer disease duration, extensive colitis, dysplasia, and primary sclerosing cholangitis were identified as important risk factors for developing CRC.
Lakatos
Laszlo
L
1st Department of Medicine, Csolnoky F. County Hospital, Veszprem, Hungary.
Mester
Gabor
G
Erdelyi
Zsuzsanna
Z
David
Gyula
G
Pandur
Tunde
T
Balogh
Mihaly
M
Fischer
Simon
S
Vargha
Peter
P
Lakatos
Peter Laszlo
PL
D000328:Adult; D017677:Age Distribution; D001707:Biopsy, Needle; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007150:Immunohistochemistry; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D016019:Survival Analysis