title: A thirty-year follow-up surveillance study for neoplasia of a dutch ulcerative colitis cohort.
abstract: BACKGROUND
  Patients with ulcerative colitis have an increased risk of developing colorectal cancer (CRC). The aim of this study is to assess the yield of surveillance colonoscopies in a tertiary referral cohort of ulcerative colitis patients and to identify different risk groups for dysplasia.
  
  
  METHODS
  A cohort of 293 patients (148 males, mean age 33.8 years at diagnosis) was built up at our center and started the surveillance program 8-12 years after start of symptoms. They underwent colonoscopies every one to three years. Endpoints were dysplasia or a (sub)total colectomy.
  
  
  RESULTS
  After a follow-up period of 10 years, the cumulative incidence of any dysplasia was 23.5%, and of CRC 4.0%. After 15 years these percentages were 33.3% and 6.8%. Patients with pancolitis (n = 178) had a significantly higher cumulative risk of dysplasia than patients with distal disease, HR 1.9 (95%CI 1.1-3.3). Patients who started surveillance at an older age are at increased risk for any dysplasia, HR 1.03 (95%CI 1.01-1.05).
  
  
  CONCLUSIONS
  This prospective surveillance study shows a high yield of dysplasia in ulcerative colitis patients. We recommend developing separate surveillance programs for different risk groups. In our opinion patients with distal colitis can follow the general population surveillance program.
authors.affiliation: Gastroenterology Department, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands.
authors.forename: J A M
authors.initials: JA
authors.lastname: Stolwijk
authors.affiliation: Gastroenterology Department, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands.
authors.forename: A M J
authors.initials: AM
authors.lastname: Langers
authors.affiliation: Gastroenterology Department, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands.
authors.forename: J C
authors.initials: JC
authors.lastname: Hardwick
authors.affiliation: Gastroenterology Department, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: Veenendaal
authors.affiliation: Gastroenterology Department, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands.
authors.forename: H W
authors.initials: HW
authors.lastname: Verspaget
authors.affiliation: Gastroenterology Department, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: van Hogezand
authors.affiliation: Gastroenterology Department, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands.
authors.forename: H F
authors.initials: HF
authors.lastname: Vasen
authors.affiliation: Gastroenterology Department, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands.
authors.forename: A E
authors.initials: AE
authors.lastname: van der Meulen-de Jong
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002471:Cell Transformation, Neoplastic; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D012306:Risk; D055815:Young Adult