title: Cause-specific mortality and 30-year relative survival of Crohn's disease and ulcerative colitis.
abstract: BACKGROUND
  Data from the northern hemisphere suggest that patients with ulcerative colitis (UC) have similar survival to the general population, whereas mortality in Crohn's disease (CD) is increased by up to 50%. There is a paucity of data from the southern hemisphere, especially in Australia.
  
  
  METHODS
  A prevalence cohort (1977-1992) of patients with inflammatory bowel disease (IBD) diagnosed after 1970 was studied. Survival status data and causes of death up to December 2010 were extracted from the National Death Index. Relative survival analysis was carried out separately for men and women.
  
  
  RESULTS
  Of 816 cases (384 men, 432 women; 373 CD, 401 UC, 42 indeterminate colitis), 211 (25.9%) had died by December 2010. Median follow-up was 22.2 years. Relative survival of all patients with IBD was not significantly different from the general population at 10, 20, and 30 years of follow-up. Separate analyses of survival in CD and UC also showed no differences from the general population. There was no difference in survival between patients diagnosed earlier (1971-1979) or later (1980-1992). At least 17% of the deaths were caused by IBD. Fatal cholangiocarcinomas were more common in IBD (P < 0.001), and fatal colorectal cancers more common in UC (P = 0.047).
  
  
  CONCLUSIONS
  In Australia, IBD patient survival is similar to the general population. In contrast to data from Europe and North America, survival in CD is not diminished in Australia. IBD caused direct mortality in 17%, especially as biliary and colorectal cancers are significant causes of death.
authors.affiliation: Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, Australia. christian.selinger@web.de
authors.forename: Christian P
authors.initials: CP
authors.lastname: Selinger
authors.forename: Jane
authors.initials: J
authors.lastname: Andrews
authors.forename: Owen F
authors.initials: OF
authors.lastname: Dent
authors.forename: Ian
authors.initials: I
authors.lastname: Norton
authors.forename: Brian
authors.initials: B
authors.lastname: Jones
authors.forename: Charles
authors.initials: C
authors.lastname: McDonald
authors.forename: James
authors.initials: J
authors.lastname: Cowlishaw
authors.forename: Gavin
authors.initials: G
authors.lastname: Barr
authors.forename: Warwick
authors.initials: W
authors.lastname: Selby
authors.forename: Rupert W
authors.initials: RW
authors.lastname: Leong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D016022:Case-Control Studies; D002423:Cause of Death; D002648:Child; D003093:Colitis, Ulcerative / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D003424:Crohn Disease / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult