title: In PSC with colitis treated with UDCA, most colonic carcinomas develop in the first years after the start of treatment.
abstract: BACKGROUND
  Patients with PSC and IBD have a high incidence of colonic carcinomas (CRC), and the annual incidence of CRC increases with duration of disease. UDCA treatment has been suggested to reduce colonic dysplasias and carcinomas.
  
  
  OBJECTIVE
  The annual incidence of colorectal carcinomas after long-term UDCA treatment was studied.
  
  
  METHODS
  Patients included in a prospective study on the outcome after ursodeoxycholic acid (UDCA) treatment were evaluated.
  
  
  RESULTS
  A total of 120 of 171 PSC patients included had IBD (108 UC and 12 CD). All patients were treated with UDCA for a median time of 6.7 years. Seven patients with PSC and IBD developed a CRC yielding a prevalence of 5.8%. In years 0-3 (n = 120) after the start of UDCA, the annual incidence rate of CRC was 0.62/100 patient years; in years 3-6 (n = 93) it increased to 1.28 and decreased thereafter in years 6-9 (n = 67) to 1.17, then in years 9-12 (n = 42) to 0 and after >12 years (n = 24) it remained 0. In PSC with IBD, Kaplan-Meier estimate of CRC formation increased with time in the first years of treatment and reached a plateau after 9 years; after treatment for ≥ 9 years, no further CRC were observed.
  
  
  CONCLUSIONS
  After the start of UDCA, the annual incidence of CRC increased up to 6 years and subsequently decreased. In PSC with IBD treated with UDCA, most colonic carcinomas develop in the first years after the start of treatment.
authors.affiliation: Department of Medicine, University of Heidelberg, Medizinische Universitätsklinik, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Rudolph
authors.forename: D N
authors.initials: DN
authors.lastname: Gotthardt
authors.forename: P
authors.initials: P
authors.lastname: Kloeters-Plachky
authors.forename: H
authors.initials: H
authors.lastname: Kulaksiz
authors.forename: P
authors.initials: P
authors.lastname: Schirmacher
authors.forename: A
authors.initials: A
authors.lastname: Stiehl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002756:Cholagogues and Choleretics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000175:diagnosis / Q000188:drug therapy*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid