P199 Identification of risk factors of colitis-associated carcinoma in Japanese patients with Ulcerative Colitis: Results from a retrospective multicenter study in a Kyoto-Shiga cohort
T. Takagi*1, T. Yoshino2, S. Bamba3, K. Uchiyama1, Y. Naito1, M. Matsuura2, H. Nakase2, T. Tsujikawa3, A. Andoh3, T. Kogawa4
1Kyoto Prefectural University of Medicine, Molecular Gastroenterology and Hepatology, Kyoto, Japan, 2Kyoto University Hospital, Department of Gastroenterology and Hepatology, Kyoto, Japan, 3Shiga University of Medical Science, Department of Medicine, Otsu, Japan, 4Kogawa Internal Medicine Clinic, Internal Medicine Clinic, Kyoto, Japan
The number of patient with ulcerative colitis (UC) has increasing in Japan. Patients with UC are at particularly risk of developing colitis-associated cancer (CAC). Therefore, to validate risk factors for CAC is helpful to stratify the individual UC patient's risk. The aim of the present study is to evaluate the risk factors for development of dysplasia and CAC as well as to determine protective measure in a large cohort of UC patients (-CAPITAL (Cohort and Practice for IBD total management in Kyoto-Shiga Links) study-).
Data were obtained from the twelve hospitals in Kyoto-Shiga regions during 2003-2013. We performed a retrospective cohort study with a total of 2137 UC patients.
Dysplasia and CAC (total 63 lesions) were detected in 44 patients (2.96%) out of 2137 patients. The mean age of these 44 patients was 53 years old. With regard to disease extension, 79.5% (35/44) of these patients had pancolitis and 18.2% had left-sided colitis. The mean duration of disease was 13.5 years (0-40 years), and 68.2% of those patients had disease duration of more than 10 years. The mean dose of corticosteroids (CS) was 8.34g, and three patients had been treated with a total of more than 10g of CS. 38.6 % (11/44) of these patients had experienced more than one year CS treatment. Primary sclerosing cholangitis was found in two patients (4.5%). 44 (69.8%) of all 63 CAC was located at distal colon. 37 (58.7%) of 63 CAC was detected as superficial type.
Our data demonstrated that disease duration of more than 10 years, long-term and high dose of CS use and pancolitis are predictive factors of CAC. Most of CAC were located at distal colon and detected as superficial type. Further investigations will be required for establishment of CAC surveillance in Japanese UC patients.