Colectomy and cancer in Melbourne children with ulcerative colitis

A search of hospital records dating from 1945 to 1977 inclusive identified 67 children with a definite diagnosis of ulcerative colitis, and 26 in whom the diagnosis was suspected, but not proven. Actuarial analysis of follow-up data available in December, 1978, indicated 75% patient survival after 18 years of disease, and 50% colon survival after 12 years of disease. Deaths were due to cancer (2 patients), complications of surgery (four patients) and incidental respiratory tract infection (one patient). Cancer risk was found to be lower than expected, which does not support the argument for prophylactic colectomy in childhood-onset disease. Restricting colectomy to medical indications during childhood will minimize the complications of colectomy without exposing the patient to risks greater than those of surgery itself.