P636. Colorectal cancers in Indian patients with ulcerative colitis
Data from Asia suggest that colorectal cancer (CRC) occurs in 0.5 to 1.8%
Methodsof patients with ulcerative colitis (UC). We report our data on CRC in UC.
Data on 430 patients (248 males [57.7%]; mean age 44 [SD 14.6] years) with UC (median disease duration 6 [interquartile range 7] years) were available for analysis from the inflammatory bowel disease database maintained since 2005. Thirty-eight (8.8%) patients had proctitis, 95 (22.1%) procto-sigmoiditis, 131 (30.5%) left-sided colitis, and 159 (37%) pancolitis; extent was unknown in 7 patients. Patients with histologically confirmed CRC within the segment with colitis were compared with those without CRC, to determine risk factors for the development of CRC.
Twelve patients (2.8%) developed CRC. The incidence density was 3.556/1000 patient-years of disease overall - 2.995/1000 in the first 10 years, 3.338/1000 at 10 to 20 years, and 7.030/1000 at >20 years. On univariate analysis, age, gender, duration of disease, extent of colitis, smoking, family history of inflammatory bowel disease, medication compliance and disease control were considered for analysis. Extensive colitis (disease extending proximal to splenic flexure) (p = 0.01), longer duration of disease (p = 0.00001) and poor control of disease (p = 0.007) were associated with development of CRC. On multivariate analysis, duration of disease (p = 0.0099) and extent of colitis (p = 0.0273) were significant factors for development of CRC.