The full content of Annals is available to subscribers

Subscribe/Learn More  >
Academia and the Profession |

Optimal Timing of Colonoscopy to Screen for Cancer in Ulcerative Colitis

[+] Article, Author, and Disclosure Information

Grant support: in part by the Gastrointestinal Research Foundation and the Cancer Research Foundation. Dr. Silverstein is a Henry J. Kaiser Family Foundation Faculty Scholar in General Internal Medicine.

▸Requests for reprints should be addressed to Bret A. Lashner, M.D.; University of Chicago Medical Center, Box 400, 5841 South Maryland Avenue; Chicago, IL 60637.

Chicago, Illinois

© 1988 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1988;108(2):274-278. doi:10.7326/0003-4819-108-2-274
Text Size: A A A

Patients with ulcerative colitis have a high risk of colon cancer that increases with duration of disease. Annual colonoscopy with biopsies for 99 patients with pancolitis and a mean duration of disease at entry of 17 years was evaluated. The outcomes of mucosal dysplasia or cancer were analyzed to determine the annual risk (hazard rate) of high-grade dysplasia or colon cancer. The hazard rates were used to recommend screening intervals. The delay in the diagnosis of cancer is minimized for any given number of tests when the time between tests is inversely proportional to the square root of the hazard rate. Since the hazard rate for cancer increases with duration of disease, intervals for screening tests should not be uniform. For a range of reasonable marginal benefits from additional testing, the number of tests recommended is less than the number of tests done in fixed-interval screening programs. Scheduling screening tests using patient-specific hazard rates to minimize the delay in the diagnosis of cancer reduces the number of colonoscopies, associated cost, and morbidity.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $40.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.