Surveillance for Colorectal Cancer Associated with Ulcerative Colitis Katsuyoshi Matsuoka 1 , Toshifumi Hibi 1 , Yasushi Iwao 1 , Makoto Naganuma 1 , Akira Okazawa 1 1Department of Internal Medicine, School of Medicine, Keio University Keyword: 潰瘍性大腸炎 , 大腸癌 , dysplasia , colitic cancer , surveillance pp.903-914
Published Date 2002/6/25
DOI https://doi.org/10.11477/mf.1403104487
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 Colorectal cancer is a major cause of an increased mortality rate in patients with longstanding ulcerative colitis (UC) . There is now general, albeit not universal, agreement that this association exists, but the magnitude of the increase in risk is a point of considerable debate. Furthermore, while surveillance colonosocpy (SCS) has been widely performed to survey colitic cancers, vigorous debate and clinical uncertainty surround the issue of whether colitic cancer can be prevented by SCS. Here we analyzed the data of 114 patients enrolled in our SCS program from 1997 to 2002. By precise endoscopic observation, target biopsies against macroscopic lesions have been performed in our SCS, while random biopsies are commonly accepted in the Western countries. Six cases of carcinoma and/or high-grade dysplasia were discovered among those patients. The prognosis of colitic cancers discovered in our SCS program was comparatively favorable. It was only 7.9% of the patients that had received SCS once per year, and the average number of times of SCS in five years was 1.9 times per patient. Indeed, it seems to be important to maintain compliance of long-standing UC patients for SCS. At present, although biannual SCS with target biopsy is thought to be an adequate method for decreasing mortality in UC, the improvement in accuracy of endoscopic observation and establishment of more efficient surveillance strategy using the molecular biological technique are desired.

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