title: Colorectal cancers in ulcerative colitis from a low-prevalence area for colon cancer.
abstract: OBJECTIVE
  To determine the incidence and risk factors for colorectal cancer (CRC) in patients with ulcerative colitis from a low prevalence region for CRC.
  
  
  METHODS
  Our prospective database yielded a cohort of 430 patients [age: 44 ± 14.6 years; 248 men (57.7%)] with ulcerative colitis (median disease duration 6, range: 1-39 years) for analysis. Of these, 131 (30.5%) had left-sided colitis and 159 (37%) extensive colitis. Patients with histologically confirmed CRC within the segment with colitis were compared with those without CRC, to determine the risk factors for the development of CRC.
  
  
  RESULTS
  Twelve patients (2.8%) developed CRC. The overall incidence density was 3.56/1000 patient-years of disease - 3/1000 in the first 10 years, 3.3/1000 at 10 to 20 years, and 7/1000 at > 20 years. Three of our 12 patients developed CRC within 8 years of disease onset. On univariate analysis, extensive colitis, longer duration of disease, and poor control of disease were associated with development of CRC. On multivariate analysis, duration of disease and extent of colitis remained significant.
  
  
  CONCLUSIONS
  CRC occurred in 2.8% of patients with ulcerative colitis in our population - an incidence density similar to that in Western countries in spite of a low overall prevalence of colon cancer in our population. The risk increased with extent and duration of disease.
authors.affiliation: Devendra Desai, Abhijit Deshmukh, Philip Abraham, Anand Joshi, Tarun Gupta, Varun Khandagale, Siji George, Division of Gastroenterology, P.D Hinduja Hospital, Mumbai 400016, India.
authors.forename: Devendra
authors.initials: D
authors.lastname: Desai
authors.affiliation: Devendra Desai, Abhijit Deshmukh, Philip Abraham, Anand Joshi, Tarun Gupta, Varun Khandagale, Siji George, Division of Gastroenterology, P.D Hinduja Hospital, Mumbai 400016, India.
authors.forename: Sudeep
authors.initials: S
authors.lastname: Shah
authors.affiliation: Devendra Desai, Abhijit Deshmukh, Philip Abraham, Anand Joshi, Tarun Gupta, Varun Khandagale, Siji George, Division of Gastroenterology, P.D Hinduja Hospital, Mumbai 400016, India.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Deshmukh
authors.affiliation: Devendra Desai, Abhijit Deshmukh, Philip Abraham, Anand Joshi, Tarun Gupta, Varun Khandagale, Siji George, Division of Gastroenterology, P.D Hinduja Hospital, Mumbai 400016, India.
authors.forename: Philip
authors.initials: P
authors.lastname: Abraham
authors.affiliation: Devendra Desai, Abhijit Deshmukh, Philip Abraham, Anand Joshi, Tarun Gupta, Varun Khandagale, Siji George, Division of Gastroenterology, P.D Hinduja Hospital, Mumbai 400016, India.
authors.forename: Anand
authors.initials: A
authors.lastname: Joshi
authors.affiliation: Devendra Desai, Abhijit Deshmukh, Philip Abraham, Anand Joshi, Tarun Gupta, Varun Khandagale, Siji George, Division of Gastroenterology, P.D Hinduja Hospital, Mumbai 400016, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Gupta
authors.affiliation: Devendra Desai, Abhijit Deshmukh, Philip Abraham, Anand Joshi, Tarun Gupta, Varun Khandagale, Siji George, Division of Gastroenterology, P.D Hinduja Hospital, Mumbai 400016, India.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Deshpande
authors.affiliation: Devendra Desai, Abhijit Deshmukh, Philip Abraham, Anand Joshi, Tarun Gupta, Varun Khandagale, Siji George, Division of Gastroenterology, P.D Hinduja Hospital, Mumbai 400016, India.
authors.forename: Varun
authors.initials: V
authors.lastname: Khandagale
authors.affiliation: Devendra Desai, Abhijit Deshmukh, Philip Abraham, Anand Joshi, Tarun Gupta, Varun Khandagale, Siji George, Division of Gastroenterology, P.D Hinduja Hospital, Mumbai 400016, India.
authors.forename: Siji
authors.initials: S
authors.lastname: George
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Colon cancer; Dysplasia; Epidemiology; Inflammatory bowel disease; Malignancy
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