Four cases are described in which ulcerative colitis was complicated by carcinoma and in which the extent of the accompanying in-situ carcinoma (precancer) was determined. The extent of the in-situ carcinoma was very variable and in all cases the rectum was spared in whole or part. Search for in-situ carcinoma in rectal biopsies will fail to indicate the development of malignancy in some patients with ulcerative colitis. Alternative methods of cancer detection in this group are discussed.
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