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| 15. |
- Karlen, P, et al.
(författare)
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Is colonoscopic surveillance reducing colorectal cancer mortality in ulcerative colitis? A population based case control study
- 1998
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Ingår i: Gut. - : BMJ. - 0017-5749 .- 1468-3288. ; 42:5, s. 711-714
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Tidskriftsartikel (refereegranskat)abstract
- Background—Colonoscopic surveillance is a standard procedure in many patients with long standing, extensive ulcerative colitis (UC), in order to avoid death from colorectal cancer. No conclusive proof of its benefits has been presented however.Aims—To evaluate the association between colonoscopic surveillance and colorectal cancer mortality in patients with UC.Patients—A population based, nested case control study comprising 142 patients with a definite UC diagnosis, derived from a study population of 4664 patients with UC, was conducted.Methods—Colonoscopic surveillance in all patients with UC who had died from colorectal cancer after 1975 was compared with that in controls matched for age, sex, extent, and duration of the disease. Information on colonoscopic surveillance was obtained from the medical records.Results—Two of 40 patients with UC and 18 of 102 controls had undergone at least one surveillance colonoscopy (relative risk (RR) 0.29, 95% confidence interval 0.06 to 1.31). Twelve controls but only one patient with UC had undergone two or more surveillance colonoscopies (RR 0.22, 95% confidence interval 0.03 to 1.74), indicating a protective dose response relation.Conclusion—Colonoscopic surveillance may be associated with a decreased risk of death from colorectal cancer in patients with long standing UC.
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| 19. |
- Lapidus, A, et al.
(författare)
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Incidence of Crohn's disease in Stockholm County 1955-1989
- 1997
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Ingår i: Gut. - : BMJ. - 0017-5749 .- 1468-3288. ; 41:4, s. 480-486
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Tidskriftsartikel (refereegranskat)abstract
- Aim—To evaluate the incidence of Crohn’s disease in Stockholm County between 1955 and 1989.Methods—A cohort of 1936 patients with Crohn’s disease was retrospectively assembled. Incidence rates and changes in disease distribution were assessed.Results—The mean increase in incidence was 15% (95% confidence intervals 12% to 18%) per five year period with a mean annual incidence rate at 4.6/105during the last two decades. The mean incidence for the entire study period was similar for men and women. The mean age at diagnosis increased from 25 years in 1960–64 to 32 years in 1985–89, partly because of an increasing proportion of patients aged at least 60 years at diagnosis. The proportion of patients with colonic Crohn’s disease at the time of diagnosis increased from 15% to 32% (17% difference; 95% confidence intervals 12% to 23%) whereas the proportion of patients with ileocaecal disease decreased from 58% to 41% (17% difference; 95% confidence intervals 10% to 24%) during the study period. Elderly patients had a higher proportion of small bowel disease and a lower proportion of ileocolonic disease compared with the younger patients.Conclusion—The incidence rate of Crohn’s disease in Stockholm has stabilised at 4.6/105 and the proportion of elderly patients has increased during a 35 year period. Colonic Crohn’s disease has increased in frequency with a reciprocal decrease in ileocaecal disease.
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