Rutter, M.D.; Saunders, B.P.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA66
Academic Journal
Background: Colonoscopic surveillance for cancer in ulcerative colitis (UC) has been performed for 30 years, yet there are few data on patients' quality of life (QOL) or views of cancer surveillance. Method: At our hospital, patients with over 8 years of extensive UC are counselled about their increased risk of colorectal cancer (CRC) & offered surveillance. A 58 question survey was sent to all patients on surveillance. Information was gathered on demographics, general health (EQ-5D), & views on surveillance, cancer risk, & surgery. Results: 332 questionnaires were sent. 1 patient had died, & 2 had moved. Of the remaining 329, 276 responded (84%). Median responder age was 55 (range 26-84; 164 male, 112 female). QOL on surveillance was high, but lower than the general population (EQ-5D visual analog scale mean 77.5, c.f. population mean 82.5; p<0.0001). There was no significant reduction in QOL with age. 84% felt the right amount of surveillance information was given, 16% too little, none too much. 92% felt explanations were easy to understand, 3% difficult, & 5% could not recall an explanation. 35% sought additional information. 98% felt surveillance important to them. 80% felt the surveillance interval about right, 11% too long, & 9% too short. 84% were worried about CRC. 96% felt reassured by surveillance, 4% felt it increased their anxieties. 2% believed surveillance completely removed cancer risk, 68% greatly reduced it, 24% moderately reduced, & 6% slightly reduced the risk. On the timing of surgery, 7% stated they would choose surgery after 10 years of colitis, 65% on dysplasia detection, 24% on CRC detection, & 4% said they would not have surgery even on CRC diagnosis. Conclusion: Responders maintain a good quality of life on surveillance. 98% feel surveillance is important to them, although 11% hypothetically opted for a management strategy other than colonoscopic surveillance (surgery at 10 years, or no surgery even on...


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