Surveillance for cancer/dysplasia in longstanding ulcerative colitis.

概要

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Patients with longstanding ulcerative colitis (UC) are at increased risk of developing carcinoma of the colon. Surveillance colonoscopy has been recommended in order to detect dysplasia and surgically treatable carcinomas. <BR>The methods and outcomes of several major surveillance programs are summarized including our data in 68 UC patients. <BR>Fifty-two (4.2 %) of 1225 patients with ulcerative colitis who had been subjected to surveillance practice were found to have carcinomas of the colon. Most of the patients had Dukes' Stage A or B carcinomas. They had the improved survival as compared to those who were not followed up by this protcol. <BR>Among these patients entered in surveillance programs, dysplasia was detected in 293 cases (24 %). This high incidence of dysplasia may indicate over-diagnosis. <BR>Surveillance program serves for the isolation of the patients at high risk of carcinoma in curative stage. More specific premalignant markers are however required to offer the best protection for the patient with longstanding ulcerative colitis against carcinoma.
日本大腸肛門病学会の論文