Long term prognosis of Crohn's disease with onset in childhood and adolescence.

Long term prognosis of Crohn's disease with onset in childhood and adolescence SIR,-In the April leading article,' the long term prognosis of Crohn's disease starting in childhood and adolescence was stated to be the same as that in adults, from which it might be assumed that age is of no significance when assessing the risk to life or the results of therapeutic trials. There is, however, strong evidence that it is not true. Data from Cardiff2 suggests an 11-fold increase in the risks of death in those diagnosed between 10 and 19 years of age and from Birmingham3 a 12-fold increase in the group less than 20 years at diagnosis. Results from the Mayo Clinic4 showed a 12-fold increase in those under 21 years at onset 20 years later while data from both Stockholm5 and Birmingham6 7 shows a six-fold increase in those aged 29 or less at diagnosis while from Oxford8 a 6-4-fold increase was found in those under the age of 40 at onset of symptoms when assessed five years later. Such increased risks contrast with the outlook in adults, particularly in those over the age of 40 at diagnosis when risks to life are not significantly different to those of the general population.2 3 7