Colorectal cancer risk is low in early onset of ulcerative colitis

This month's Journal of Pediatric Gastroenterology & Nutrition examines colorectal cancer and primary sclerosing cholangitis in early onset ulcerative colitis.

Ulcerative colitis is associated with an increased risk of colorectal cancer and primary sclerosing cholangitis.

Ulcerative colitis at a young age is a specific risk factor for colorectal cancer.

Dr Jan Lindberg and colleagues examined the outcome with respect to DNA aneuploidy, dysplasia, colorectal cancer, and primary sclerosing cholangitis in a cohort of patients with early-onset ulcerative colitis.

Patients were from a defined catchment area who were followed up for 45 years between 1961 and 2005.

Colorectal cancer developed in 1 patient

Journal of Pediatric Gastroenterology & Nutrition

The team found in that in all, 46 children and adolescents, ages 18 or younger were affected with ulcerative colitis during this time.

The team collected data from their colonoscopic surveillance program, and other medical records in the same hospital.

The researchers found that the incidence rate of ulcerative colitis was 2 children or adolescents per 100,000 inhabitants per year.

The onset of disease was at age 14 years, and the observed duration of disease was 0 to 44 years.

The team observed that 5 patients died, of which 3 had intercurrent disease.

The research team observed that colorectal cancer developed in 1 patient, and no death was caused by this disease.

Primary sclerosing cholangitis was diagnosed in 4 patients, in all of whom the onset of ulcerative colitis occurred before age 15.

Dr Lindberg‘s team concluded, "The earlier reports of increased risk of colorectal cancer in patients with early-onset ulcerative colitis was not seen in this study."

"This could be due to a high frequency of surgery together with a well-functioning surveillance program with excellent compliance."

"The recommendation of surgery in cases of high-grade dysplasia or repeated findings of low-grade dysplasia seems to be effective in the attempt to minimize the risk for colorectal cancer."

"We observed a rather high incidence of primary sclerosing cholangitis, which may indicate that more attention should be paid to a search for this diagnosis in patients with early-onset ulcerative colitis."