Colonoscopic surveillance improves survival after colorectal cancer diagnosis in inflammatory bowel disease.

Abstract:

BACKGROUND:Colonoscopic surveillance provides the best practical means for preventing colorectal cancer (CRC) in inflammatory bowel disease (IBD) patients. Strong evidence for improved survival from surveillance programmes is sparse. METHOD:The aim of this study was to compare tumour stage and survival of IBD patients with CRC who were a part of a surveillance programme with those who were not. A nationwide pathology database (PALGA (pathologisch anatomisch landelijk geautomatiseerd archief)) was consulted to identify IBD patients with CRC treated in all eight university hospitals in The Netherlands over a period of 15 years. Patients were assigned to the surveillance group when they had undergone one or more surveillance colonoscopies before a diagnosis of CRC. Patients who had not undergone surveillance served as controls. Tumour stage and survival were compared between the two groups. RESULTS:A total of 149 patients with IBD-associated CRC were identified. Twenty-three had had colonoscopic surveillance before CRC was discovered. The 5-year CRC-related survival rate of patients in the surveillance group was 100% compared with 74% in the non-surveillance group (P=0.042). In the surveillance group, only one patient died as a consequence of CRC compared with 29 patients in the control group (P=0.047). In addition, more early tumour stages were found in the surveillance group (P=0.004). CONCLUSIONS:These results provide evidence for improved survival from colonoscopic surveillance in IBD patients by detecting CRC at a more favourable tumour stage.

journal_name

Br J Cancer

authors

Lutgens MW,Oldenburg B,Siersema PD,van Bodegraven AA,Dijkstra G,Hommes DW,de Jong DJ,Stokkers PC,van der Woude CJ,Vleggaar FP

doi

10.1038/sj.bjc.6605359

subject

Has Abstract

pub_date

2009-11-17 00:00:00

pages

1671-5

issue

10

eissn

0007-0920

issn

1532-1827

pii

6605359

journal_volume

101

pub_type

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