Colonoscopic surveillance improves survival after colorectal cancer diagnosis in inflammatory bowel disease

M. W. M. D. Lutgens, B. Oldenburg, P. D. Siersema, A. A. van Bodegraven, G. Dijkstra, D. W. Hommes, D. J. de Jong, P. C. F. Stokkers, C. J. van der Woude, F. P. Vleggaar*, ICC

*Corresponding author for this work

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BACKGROUND: Colonoscopic surveillance provides the best practical means for preventing colorectal cancer (CRC) in inflammatory bowel disease (IBD) patients. Strong evidence for improved survival from surveillance programmes is sparse.

METHOD: The aim of this study was to compare tumour stage and survival of IBD patients with CRC who were a part of a surveillance programme with those who were not. A nationwide pathology database (PALGA (pathologisch anatomisch landelijk geautomatiseerd archief)) was consulted to identify IBD patients with CRC treated in all eight university hospitals in The Netherlands over a period of 15 years. Patients were assigned to the surveillance group when they had undergone one or more surveillance colonoscopies before a diagnosis of CRC. Patients who had not undergone surveillance served as controls. Tumour stage and survival were compared between the two groups.

RESULTS: A total of 149 patients with IBD-associated CRC were identified. Twenty-three had had colonoscopic surveillance before CRC was discovered. The 5-year CRC-related survival rate of patients in the surveillance group was 100% compared with 74% in the non-surveillance group (P = 0.042). In the surveillance group, only one patient died as a consequence of CRC compared with 29 patients in the control group (P = 0.047). In addition, more early tumour stages were found in the surveillance group (P = 0.004).

CONCLUSIONS: These results provide evidence for improved survival from colonoscopic surveillance in IBD patients by detecting CRC at a more favourable tumour stage.

British Journal of Cancer (2009) 101, 1671-1675. doi: 10.1038/sj.bjc.6605359

Published online 13 October 2009 (C) 2009 Cancer Research UK

Original languageEnglish
Pages (from-to)1671-1675
Number of pages5
JournalBritish Jounal of Cancer
Issue number10
Publication statusPublished - 10-Nov-2009


  • inflammatory bowel disease
  • colorectal cancer
  • surveillance
  • survival
  • tumour stage
  • IBD
  • CRC

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