Abstract
The cancer risk in Crohn's disease is less well defined than that in ulcerative colitis. The risk of developing colorectal cancer has been compared in two identically selected cohorts of previously hospitalized patients with extensive Crohn's colitis (n = 125) and extensive ulcerative colitis (n = 486). Patients were selected who were 15 years or older at the time of onset of symptoms. The number of cancers expected was computed using a totalperson-years-at-risk program. Eight colorectal cancers were found in patients with extensive colitis, and this was a highly significant 18-fold excess risk when corrected for surgical resections. This risk was similar to the 19-fold excess risk in patients with extensive ulcerative colitis. The 29 colorectal carcinomas were much greater than expected. The absolute cumulative frequency of colorectal cancer in patients with extensive colitis was 8% at 22 years from the onset in patients with Crohn's disease and 7% at 20 years in patients with ulcerative colitis. The relative risk was increased in both groups when the colitis started before age 25.
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