2024-03-29T08:51:41Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00019171
2023-11-16T05:21:55Z
499:508:509:1674
Suitability of Surveillance Colonoscopy for Patients with Ulcerative Colitis to Detect Colorectal Cancer: Current Guidelines Miss Some Early-Sage Cases
KAMIYA, TORU
56085
ANDO, TAKAFUMI
56086
WATANABE, OSAMU
56087
NAKAMURA, MASANAO
56088
YAMAMURA, TAKESHI
56089
MIYAHARA, RYOJI
56090
HIROOKA, YOSHIKI
56091
GOTO, HIDEMI
56092
surveillance colonoscopy
ulcerative colitis
colorectal cancer
2015-02
Surveillance colonoscopy (SC) is considered important for the early detection and treatment of colorectal cancer (CRC) in patients with ulcerative colitis (UC). Here, we investigated whether current guidelines are appropriate in preventing UC patients from being diagnosed with CRC at an incurable stage. Among 1583 patients under treatment for UC, 27 patients were diagnosed with CRC. Of these, we excluded two patients who had not undergone colonoscopy before CRC diagnosis. We then divided the remaining patients into three groups based on colonoscopy interval (A, 1 year or less; B, between 1 and 2 years; and C, 2 years or longer). Fifteen patients had tubular adenocarcinomas, and 10 had other types (8 poorly differentiated adenocarcinomas, 1 mucinous adenocarcinoma, 1 endocrine cell carcinoma). Five (20%) of 25 patients developed CRC within 8 years after the onset of UC, of which one case was detected at stage IV. Six patients were classified into group A, 8 into group B, and 11 into group C. On distribution by histologic type, tubular adenocarcinomas were detected in stages 0 - II in 100% in group A, 100% in group B, and 57.1% in group C. In contrast, other types of carcinomas were detected in stage 0 - II in 100% in group A, 40% in group B, and 0% in group C. Current guideline recommendations for SC are not sufficient for the detection of early stage CRC in patients with UC. SC should be commenced earlier than recommended in the current guidelines and repeated annually.
departmental bulletin paper
Nagoya University School of Medicine
2015-02
Nagoya Journal of Medical Science
1-2
77
237
244
http://hdl.handle.net/2237/21277
2186-3326
0027-7622
eng
http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/7712.html