title: Risk factors for developing colorectal cancer in Japanese patients with ulcerative colitis: a retrospective observational study-CAPITAL (Cohort and Practice for IBD total management in Kyoto-Shiga Links) study I.
abstract: OBJECTIVE
  Patients with ulcerative colitis (UC) are at risk for developing colorectal cancer (CRC), despite the development of new therapeutic agents. Stratification of the individual UC-patient's risk would be helpful to validate the risk factors for CRC. The aim of this study was to evaluate the risk factors for the development of CRC in a large cohort of patients with UC.
  
  
  METHODS
  Data were obtained from 12 hospitals in the Kyoto-Shiga region during 2003-2013. We performed a retrospective cohort study of 2137 patients with UC.
  
  
  RESULTS
  In total, 60 lesions of CRC were detected in 43 (2.0%) of 2137 patients. 30 of the 43 patients were male. The median age was 53 years. The median duration of disease was 13 years, and 67.4% of these patients had a disease duration >10 years. Of the 43 patients, 34 (79.1%) had extensive colitis. Primary sclerosing cholangitis was detected in 2 patients (4.7%). The median corticosteroids (CS) dose was 6.4 g, and 4 patients were treated with a total of more than 10 g of CS. 18 of these patients underwent more than 1 year CS treatment. Of all 60 CRC lesions, 43 (71.7%) were located in the distal colon and 35 (58.3%) were of the superficial type. Moreover, the stage of CRC was stage 0 or I in 55.8% of the 43 patients with CRC. Multivariate analysis suggested that extensive colitis could be a risk factor for the development of advanced CRC in patients with UC.
  
  
  CONCLUSIONS
  Our findings indicated that male, extensive colitis, long-term duration of UC and family history of CRC, but not concomitant primary sclerosing cholangitis, are important factors for predicting CRC in Japanese patients with UC. Moreover, long-standing extensive colitis might contribute to the progression of CRC. Further studies are required to establish CRC surveillance in Japanese patients with UC.
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Division of Gastroenterology and Hepatology, Digestive Disease Center, Kitano Hospital, Osaka, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Yoshino
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Gastroenterology & Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakase
authors.affiliation: Molecular Gastroenterology and Hepatology , Kyoto Prefectural University of Medicine, Graduate School of Medical Science , Kyoto , Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Division of Gastroenterology , Shiga University of Medical Science Hospital , Otsu , Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Bamba
authors.affiliation: Department of Gastroenterology and Hepatology , Japanese Red Cross Kyoto Daiichi Hospital , Kyoto , Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okuyama
authors.affiliation: Department of Gastroenterology , Kyoto Second Red Cross Hospital , Kyoto , Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Kawamura
authors.affiliation: Oki Clinic , Kyoto , Japan.
authors.forename: Teruki
authors.initials: T
authors.lastname: Oki
authors.affiliation: Obata Medical Clinic , Kyoto , Japan.
authors.forename: Hirozumi
authors.initials: H
authors.lastname: Obata
authors.affiliation: Department of Gastroenterology and Hepatology , Japanese Red Cross Otsu Hospital , Otsu , Japan.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kawanami
authors.affiliation: Department of Gastroenterology and Hepatology , National Hospital Organization, Kyoto Medical Center , Kyoto , Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Katsushima
authors.affiliation: Division of Gastroenterology and Hepatology , Digestive Disease Center, Kyoto Katsura Hospital , Kyoto , Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kusaka
authors.affiliation: Department of Gastroenterology and Hepatology , National Hospital Organization, Higashi-Ohmi Medical Center , Higashi-Ohmi , Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tsujikawa
authors.affiliation: Molecular Gastroenterology and Hepatology , Kyoto Prefectural University of Medicine, Graduate School of Medical Science , Kyoto , Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Naito
authors.affiliation: Division of Gastroenterology , Shiga University of Medical Science Hospital , Otsu , Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Andoh
authors.affiliation: Kogawa Internal Medicine Clinic , Kyoto , Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Kogawa
keywords: COLORECTAL CANCER; SURVEILLANCE; ULCERATIVE COLITIS