A new study from Karolinska Institutet in Sweden reveals that individuals diagnosed with ulcerative proctitis do not have a higher risk of developing rectal cancer compared to the general population. Published in the journal Gastroenterology, this research may lead to more tailored follow-up care for patients suffering from inflammatory bowel disease (IBD).
Ulcerative proctitis is a milder form of ulcerative colitis, characterized by inflammation limited to the rectum. While ulcerative colitis has been associated with an increased risk of cancers in the colon and rectum, the correlation for ulcerative proctitis has previously remained uncertain. The findings from this study provide clarity on this important issue.
Researchers identified nearly 16,000 individuals in Sweden diagnosed with isolated ulcerative proctitis between 1997 and 2023. They compared these patients to a control group of just over 158,000 people from the general population without IBD. By linking various national health registries, participants were followed for a median period exceeding ten years.
The results indicated that the incidence of rectal cancer and precancerous lesions, identified as high-grade dysplasia, was low in both groups. After ten years of monitoring, approximately 0.2 percent of individuals in each group developed rectal cancer. Additionally, the study found no increased risk of rectal cancer in patients who later progressed to more widespread forms of colitis.
Åsa Hallqvist Everhov, senior physician in surgery and associate professor at the Department of Clinical Epidemiology at Karolinska Institutet, commented on the findings, stating, “Our results are reassuring for patients with ulcerative proctitis. Despite long-term inflammation in the rectum, we see no increased risk of cancer compared to the general population.”
The study’s co-author, Ola Olén, senior physician in pediatric gastroenterology, highlighted the implications of the research. He stated, “This supports a more individualized approach to cancer surveillance in inflammatory bowel disease, where the extent of the disease plays a crucial role.”
This research utilized comprehensive data from several national registries, including the IBD registry SWIBREG, the Cancer Registry, and the Patient Registry. Funding for the study came from various sources, including the Swedish Research Council, the Cancer Foundation, the Bengt Ihre Foundation, and ALF funds from Region Stockholm. Some researchers disclosed research collaborations or support from pharmaceutical companies, while others reported no conflicts of interest.
The full study, titled “Incidence of Rectal Cancer in Patients with Isolated Ulcerative Proctitis – A Population-Based Cohort Study,” is accessible in the Gastroenterology journal as of February 3, 2026. The findings are expected to influence future guidelines and patient management strategies for those with ulcerative proctitis, potentially easing concerns about cancer risks associated with this condition.
