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We aimed to provide a comprehensive description of the natural course of UC in China and compare it with Western UC patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Based on a prospective Chinese nationwide registry of consecutive patients with inflammatory bowel diseases, the medical treatments and natural history of UC were described in detail, including disease extension, surgery, and neoplasia. The Cox regression model was used to identify factors associated with poor outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1081 UC patients were included with a median follow\u2010up duration of 5.3\u00a0years. The overall cumulative exposure was 99.1% to 5\u2010aminosalicylic acids, 52.1% to corticosteroids, 25.6% to immunomodulators, and 15.4% to biologics. Disease extent at diagnosis was proctitis in 26.9%, left\u2010sided colitis in 34.8%, and extensive colitis in 38.3%. Of 667 patients with proctitis and left\u2010sided colitis, 380 (57.0%) experienced disease extent progression. A total of 58 (5.4%) UC patients underwent colectomy, demonstrating cumulative proportions of surgery at 1, 5, and 10\u00a0years after diagnosis of 0.6%, 3.4%, and 8.2%, respectively. In addition, 23 (2.1%) UC patients were diagnosed with neoplasia, demonstrating cumulative proportions of neoplasia at 1, 5, and 10\u00a0years after diagnosis of 0.5%, 1.0%, and 3.5%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Chinese UC patients had similar cumulative proportions of exposure to IBD\u2010specific treatments but a lower surgical rate than patients in Western countries, indicating a different natural course, and close monitoring needs for UC in China. However, these results must be confirmed in population\u2010based studies because the hospital\u2010based cohort in our study might lead to selection bias.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12634","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T12:50:05Z","timestamp":1721393405000},"page":"1167-1178","source":"Crossref","is-referenced-by-count":14,"title":["Natural course of ulcerative colitis in China: Differences from the West?"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9941-0576","authenticated-orcid":false,"given":"Jian","family":"Wan","sequence":"first","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases Xijing Hospital of Digestive Diseases Fourth Military Medical University  Xi'an 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