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Inflammatory bowel disease
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
  1. Takuya Yoshino1,2,
  2. Hiroshi Nakase1,3,
  3. Tomohisa Takagi4,
  4. Shigeki Bamba5,
  5. Yusuke Okuyama6,
  6. Takuji Kawamura7,
  7. Teruki Oki8,
  8. Hirozumi Obata9,
  9. Chiharu Kawanami10,
  10. Shinji Katsushima11,
  11. Toshihiro Kusaka12,
  12. Tomoyuki Tsujikawa13,
  13. Yuji Naito4,
  14. Akira Andoh5,
  15. Takafumi Kogawa14
  1. 1Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  2. 2Division of Gastroenterology and Hepatology, Digestive Disease Center, Kitano Hospital, Osaka, Japan
  3. 3Department of Gastroenterology & Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
  4. 4Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
  5. 5Division of Gastroenterology, Shiga University of Medical Science Hospital, Otsu, Japan
  6. 6Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
  7. 7Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan
  8. 8Oki Clinic, Kyoto, Japan
  9. 9Obata Medical Clinic, Kyoto, Japan
  10. 10Department of Gastroenterology and Hepatology, Japanese Red Cross Otsu Hospital, Otsu, Japan
  11. 11Department of Gastroenterology and Hepatology, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
  12. 12Division of Gastroenterology and Hepatology, Digestive Disease Center, Kyoto Katsura Hospital, Kyoto, Japan
  13. 13Department of Gastroenterology and Hepatology, National Hospital Organization, Higashi-Ohmi Medical Center, Higashi-Ohmi, Japan
  14. 14Kogawa Internal Medicine Clinic, Kyoto, Japan
  1. Correspondence to Professor Hiroshi Nakase; hiro_nakase{at}sapmed.ac.jp

Abstract

Background and Aims 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.

  • ULCERATIVE COLITIS
  • COLORECTAL CANCER
  • SURVEILLANCE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjgast-2016-000122

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