Clinical–alimentary tractPredictive and Protective Factors Associated With Colorectal Cancer in Ulcerative Colitis: A Case-Control Study
Section snippets
Source Population
The Institutional Review Board of the Mayo Foundation approved the research protocol. A comprehensive Mayo Clinic centralized diagnostic index, utilizing inpatient and outpatient discharge diagnoses, pathology reports, and endoscopic reports, identified all patients with CUC evaluated at the Mayo Clinic Rochester between January 1, 1976, and December 31, 2002 (N = approximately 11,800). Inclusion into the study as either a case or control required a clinical, histologic, and endoscopic or
Study Population
Controls were gender- and disease extent-matched (Table 1). They were chosen to be similar to matched cases with respect to the duration of CUC. The majority of the study population was male and white. Most patients had extensive colitis; only 2 cases and 2 controls (1%) had proctitis. The distribution of geographic residence was approximately equal among cases and controls and evenly spread across the 3 categories. Approximately half of the cases were diagnosed before the midpoint of the study
Discussion
To identify potentially important CRC prevention strategies and high-risk subgroups, we investigated several predictive and protective factors associated with CRC. In a large tertiary care population of CUC patients, the 2 most important predictive factors for CRC (after matching for anatomic extent and duration of disease) were having a first-degree relative with CRC and having a prior diagnosis of pseudopolyps. The most influential protective factors (again after matching for anatomic extent
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Supported in part by Procter and Gamble Pharmaceuticals and the Mayo Foundation for Medical Education and Research.