Inflammatory bowel disease in Barbados, West Indies - abstract

The incidence and prevalence of inflammatory bowel disease (IBD) in the West Indies is unknown. Barbados is a small West Indian island with a 1990 population of 260,491 persons; 92 percent of these are black (African or mixed African in origin). A prospective study of all patients diagnosed with ulcerative colitis (UC) or Crohn's disease (CD) between January, 1984 and December, 1993 was used to calculate the incidence and point prevalence of IBD. At December 1993, there were 60 patients with UC, 43 were diagnosed in the period under study. The point prevalence was 23/100,000 population and average incidence 1.65/100,000/year. At December 1993, there were 29 patients with CD, 25 having been diagnosed during the period of study. The point prevalence for CD at December 1993 was 11.1/100,000 population and the average incidence 0.96/100,000/year. The age specific incidence for ages 20 years and over was 2.24/100,000/year for UC and 1.26/100,000/year for CD (AU)

Family studies in colon cancer - abstract

Colon cancer is the commonest cancer in the Western world with the exception of skin cancer. More men die of lung cancer and more women die of breast cancer but mainly because these are more lethal tumours. The prognosis for cure of early colon cancer is excellent, however. It is generally accepted that almost all of colon cancers start out as benign polyps. There is considerable evidence that aggressive treatment of polyps can prevent colon cancer. The challenge therefore is to identify patients at risk of colon cancer or those having colonic polyps, diagnosing the malignant tumours early and in identifying and removing the polyps before they become malignant. High risk groups for colon cancer include people who have had previous cancer, patients known to have had colonic polyps, patients with inflammatory bowel disease (ulcerative colitis) and first degree relatives of patients with colon cancer. We investigated asymptomatic relatives of patients who had colon cancer. Our study had two objectives. The first was to prove our hypothesis that these patients would have polyps at a higher rate than the general population which is about 10 percent. The second was to test the actual feasibility of doing aggressive G.I. investigations on asymptomatic individuals, who are first degree relatives of patients with colon cancer. Approximately 200 relatives of about 35 patients with colon cancer were examined. A little under 40 percent of these people had adenomatous polyps. This is approximately 3« to 4 times the risk of having polyps in the general population. This observation needs to be confirmed in a larger series and in different populations (such as the West Indies). If these results are confirmed, then they have important implications not only for the management of patients and their families but for all those who have first degree relatives who develop colon cancer (AU)