Ulcerative colitis and colorectal disease: a population-based study

Article Abstract:

Ulcerative inflammation of the colon is well-established as an important risk factor for the eventual development of colorectal cancer. However, studies published in the medical literature differ widely in the evaluation of the exact level of risk conferred by ulcerative colitis. Such questions about long-term risks for disease are best answered in countries like Sweden, in which each citizen has a unique registration number; this number may be used to follow a patient's medical history throughout life. Using this national registry, 3,117 patients were identified who were given a diagnosis of ulcerative colitis between the years of 1922 and 1983; these patients were followed through 1984. The records yielded 92 cases of colorectal cancer occurring in 91 patients. Patient age at initial diagnosis was a strong risk factor, and children under the age of 15 who were diagnosed with ulcerative colitis had the highest risk for colorectal cancer. Among patients with pancolitis, or the involvement of the entire colon, the cumulative incidence of colorectal cancer 35 years after diagnosis was 30 percent. That is, 3 out of 10 patients with a diagnosis of pancolitis developed colorectal cancer within 35 years. This represents an increased risk almost 15 times greater than normal. Among patients diagnosed prior to the age of 15, the cumulative incidence of colorectal cancer was 40 percent after 35 years. The authors suggest that this incidence is sufficiently high that prophylactic proctocolectomy, surgical excision of the rectum and colon, might be considered for this group. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Colorectal cancer, Colitis

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The risk of esophageal cancer in patients with achalasia: a population-based study

Article Abstract:

People with esophageal achalasia have an increased risk for esophageal cancer but it may be very expensive to screen them for cancer. Esophageal achalasia occurs when the lower part of the esophagus does not relax sufficiently for food to pass through. Researchers found 1,062 people with esophageal achalasia through the Swedish Inpatient Registry. Twenty-four eventually developed esophageal cancer. The risk of developing esophageal cancer was over 100 times that in the general population during the first year after a diagnosis of achalasia, but stabilized at 16 to 17 times greater thereafter. The risk of developing pancreatic cancer or stomach cancer was also greater in those with achalasia than in the general population but this was not true of other cancers. It would be necessary to examine 681 people with achalasia to detect one case of cancer.

Diagnosis, Pancreatic cancer, Esophagus, Stomach cancer, Esophageal cancer, Diffuse esophageal spasm, Achalasia

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Appendectomy and protection against ulcerative colitis

Article Abstract:

People who have their appendix removed are less likely to develop ulcerative colitis, an inflammatory bowel disease. This was the conclusion of a study of 212,963 patients who had their appendix removed and 212,963 who did not. The exact reason for the protective effect of an appendectomy is not known.

Health aspects, Prevention, Appendectomy

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