PREVALENCE OF INFLAMMATORY BOWEL DISEASE (IBD) IN A COLORECTAL CANCER POPULATION SCREENING PROGRAM

Aims:

iBD are diagnosed in subjects with gastrointestinal symptoms and a diagnostic delay is often observed. IBD may also be present in asymptomatic subjects. In these cases, diagnosis may be further delayed or missed.

Methods:

we analyzed an electronic database of a regional colorectal cancer screening program offered to subjects from 50 to 70 years old.. From september 2013 to August 2018, among subjects who underwent colonoscopy in a single hospital, we identified subjects with endoscopic findings suggestive of IBD. We retrieved histological findings and information on other examinations and possible therapeutic decisions.

Results:

2062 subjects undergoing to colonoscopy were enrolled. In 33 (1.6%) subjects (18 men, mean age ± SD 60.8 ± 7.4 years) endoscopic findings suggestive of IBD were present: 23 of CD and 10 of UC; none of these subjects were taking oral anticoagulants or NSAIDs and reported gastrointestinal symptoms. After a median follow-up of 13 months (range 2 – 59), a definitive diagnosis of IBD was done in 10 subjects (0.5%). 3 already underwent to colonoscopy in the context of the same program and 1 showed familiarity for IBD. 7 were diagnosed with CD (6 men, 61.3 ± 7.1 years) and 3 with UC (2 men, 55.8 ± 3.0 years). In CD population, 4 patients showed colonic, 3 ileal and 1 ileo-colonic location; 1 was treated with steroids and then with vedolizumab, 1 with steroids and then with azathioprine, 1 with 5-ASA while 4 did not receive any therapy. In UC population, 2 patients showed extension limited to rectum and 1 to rectum and sigmoid colon; all patients started therapy with 5-ASA.

Conclusions:

Prevalence of IBD in a colorectal cancer population screening program is 0.5%. IBD diagnosis can be missed but only 1 out of 3 subjects with endoscopic findings suggestive of IBD is eventually diagnosed as affected by CD or UC.