Risk of Ulcerative Colitis-Associated Colorectal Cancer in China: A Multi-Center Retrospective Study - Digestive Diseases and Sciences
- ️Jiang, Bo
- ️Thu Sep 22 2011
Abstract
Background
The number of patients with ulcerative colitis (UC) in China has increased in the past 10 years. Thus, it is anticipated that the incidence of UC-associated colorectal cancer (UC-CRC) will also increase. However, the risk of CRC in UC patients is still unknown in Chinese. The aim of this study was to identify the risk and risk factors of UC-CRC in Chinese.
Methods
A total of 3,922 patients with UC were retrospectively collected from five central teaching hospitals in China, in which high-quality endoscopic and histological diagnoses were available from 1998 to 2009. The database of the UC and UC-associated CRC patients was evaluated.
Results
CRC was diagnosed 34 in patients, and the overall prevalence of CRC in patients with UC was 0.87%. The cumulative risk of developing CRC after a disease duration of 10 years was 1.15% (95% confidence interval [CI] 0.71–1.84%); 20 years, 3.56% (95% CI 2.14–5.89%); and 30 years, 14.36% (95% CI 7.57–26.3%). Longer disease duration, extensive colitis, and dysplasia found in the biopsy specimen were identified as risk factors for developing CRC. 5-ASA use was identified as a protective factor of UC-CRC.
Conclusions
The period prevalence of CRC was lower than that reported from the West. However, the cumulative risk was found to be comparable to that of Western countries, which suggests that the period prevalence of UC-CRC in China may be growing in the future.
Access this article
Subscribe and save
- Get 10 units per month
- Download Article/Chapter or eBook
- 1 Unit = 1 Article or 1 Chapter
- Cancel anytime
Buy Now
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Instant access to the full article PDF.

Similar content being viewed by others
References
Munkholm P. Review article: the incidence and prevalence of colorectal cancer in inflammatory bowel disease. Aliment Pharmacol Ther. 2003;18:1–5.
Lakatos PL, Lakatos L. Risk for colorectal cancer in ulcerative colitis: changes, causes and management strategies. World J Gastroenterol. 2008;7:3937–3947.
Crohn B, Rosenberg H. The sigmoidoscopic picture of chronic ulcerative colitis (non-specific). Am J Med Sci. 1925;170:220–228.
Eaden JA, Abrams KR, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut. 2001;48:526–535.
Lennard-Jones JE, Morson BC, Ritchie JK, et al. Cancer surveillance in ulcerative colitis: experience over 15 years. Lancet. 1983;2:149–152.
Eaden J. Review article: colorectal carcinoma and inflammatory bowel disease. Aliment Pharmacol Ther. 2004;20:24–30.
Ekbom A, Helmick C, Zack M, et al. Ulcerative colitis and colorectal cancer. A population-based study. N Engl J Med. 1990;323:1228–1233.
Karlen P, Lofberg R, Brostrom O, et al. Increased risk of cancer in ulcerative colitis: a population-based cohort study. Am J Gastroenterol. 1999;94:1047–1052.
Maratka Z, Nedbal J, Kocianova J, et al. Incidence of colorectal cancer in proctocolitis: a retrospective study of 959 cases over 40 years. Gut. 1985;26:43–49.
Loftus EV Jr. Epidemiology and risk factors for colorectal dysplasia and cancer in ulcerative colitis. Gastroenterol Clin North Am. 2006;35:517–531.
Lakatos L, Mester G, Erdelyi Z, et al. Risk factors for ulcerative colitis-associated colorectal cancer in a Hungarian cohort of patients with ulcerative colitis: results of a population-based study. Inflamm Bowel Dis. 2006;12:205–211.
Kim BJ, Yang SK, Kim JS, et al. Trends of ulcerative colitis-associated colorectal cancer in Korea: a KASID study. J Gastroenterol Hepatol. 2009;24:667–671.
Venkataraman S, Mohan V, Ramakrishna BS, et al. Risk of colorectal cancer in ulcerative colitis in India. J Gastroenterol Hepatol. 2005;20:705–709.
Jiang L, Xia B, Li J, et al. Retrospective survey of 452 patients with inflammatory bowel disease in Wuhan city, central China. Inflamm Bowel Dis. 2006;12:212–217.
Yun J, Xu CT, Pan BR. Epidemiology and gene markers of ulcerative colitis in the Chinese. World J Gastroenterol. 2009;15:788–803.
Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol. 1989;24:2–6.
Kudo S, Tamura S, Nakajima T, et al. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc. 1996;44:8–14.
Hendriksen C, Kreiner S, Binder V. Long-term prognosis in ulcerative colitis based on results from a regional patient group from the county of Copenhagen. Gut. 1985;26:158–163.
Kewenter J, Ahlman H, Hulten L. Cancer risk in extensive ulcerative colitis. Ann Surg. 1978;188:824–828.
Rutter M, Saunders B, Wilkinson K, et al. Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis. Gastroenterology. 2004;126:451–459.
Gupta RB, Harpaz N, Itzkowitz S, et al. Histologic inflammation is a risk factor for progression to colorectal neoplasia in ulcerative colitis: a cohort study. Gastroenterology. 2007;133:1099–1105. quiz 1340-1341.
Brown JB, Lee G, Managlia E, et al. Mesalamine inhibits epithelial beta-catenin activation in chronic ulcerative colitis. Gastroenterology. 2010;138:595–605.
Terdiman JP, Steinbuch M, Blumentals WA, Ullman TA, Rubin DT. 5-Aminosalicylic acid therapy and the risk of colorectal cancer among patients with inflammatory bowel disease. Inflamm Bowel Dis. 2007;13(4):367–371.
Bernstein CN, Blanchard JF, Metge C, et al. Does the use of 5-aminosalicylates in inflammatory bowel disease prevent the development of colorectal cancer? Am J Gastroenterol. 2003;98:2784–2788.
Shanahan F. Review article: colitis-associated cancer—time for new strategies. Aliment Pharmacol Ther. 2003;18:6–9.
Eaden JA, Mayberry JF, British Society for Gastroenterology, Association of Coloproctology for Great Britain, Ireland. Guidelines for screening and surveillance of asymptomatic colorectal cancer in patients with inflammatory bowel disease. Gut. 2002;51:V10–V12.
Itzkowitz SH, Present DH, Crohn’s and Colitis Foundation of America Colon Cancer in IBD Study Group. Consensus conference: Colorectal cancer screening and surveillance in inflammatory bowel disease. Inflamm Bowel Dis. 2005;11:314–321.
Loftus EV Jr, Harewood GC, Loftus CG, et al. PSC-IBD: a unique form of inflammatory bowel disease associated with primary sclerosing cholangitis. Gut. 2005;54:91–96.
Pinczowski D, Ekbom A, Baron J, et al. Risk factors for colorectal cancer in patients with ulcerative colitis: a case control study. Gastroenterology. 1994;107:117–120.
Author information
Authors and Affiliations
Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, People’s Republic of China
Wei Gong, Ye Chen & Bo Jiang
Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, People’s Republic of China
Nonghua Lv
Department of Gastroenterology, The General Hospital of Tianjin Medical University, Tianjin, 300052, People’s Republic of China
Bangmao Wang
Department of Gastroenterology, The First Affiliated Hospital of Inner Mongolia Medical Collage, Hohhot, 100050, Inner Mongolia, People’s Republic of China
Yinglong Huang
Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang University, Hangzhou, 310009, Zhejiiang, People’s Republic of China
Wenshen Pan
Authors
- Wei Gong
You can also search for this author in PubMed Google Scholar
- Nonghua Lv
You can also search for this author in PubMed Google Scholar
- Bangmao Wang
You can also search for this author in PubMed Google Scholar
- Ye Chen
You can also search for this author in PubMed Google Scholar
- Yinglong Huang
You can also search for this author in PubMed Google Scholar
- Wenshen Pan
You can also search for this author in PubMed Google Scholar
- Bo Jiang
You can also search for this author in PubMed Google Scholar
Corresponding author
Correspondence to Bo Jiang.
Rights and permissions
About this article
Cite this article
Gong, W., Lv, N., Wang, B. et al. Risk of Ulcerative Colitis-Associated Colorectal Cancer in China: A Multi-Center Retrospective Study. Dig Dis Sci 57, 503–507 (2012). https://doi.org/10.1007/s10620-011-1890-9
Received: 19 November 2010
Accepted: 17 August 2011
Published: 22 September 2011
Issue Date: February 2012
DOI: https://doi.org/10.1007/s10620-011-1890-9