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P337. Incidental diagnosis of inflammatory bowel disease during bowel cancer screening programme in Northeast Italy

M. Marino, E. Zucchi, D. Checchin, I. Lodolo, D. Berretti, R. Maieron, M. Zilli

Gastroenterology, University Hospital of Udine, Udine, Italy

Introduction and Aims: Prevalence of asymptomatic patient with IBD (inflammatory bowel disease) is poorly known. Bowel Cancer Screening Programme (BCSP) in our region (Friuli Venezia Giulia) aims to identify individuals between 50 and 69 years at risk for bowel cancer. Subjects aged 50–69 are being invitated to complete one single immunochemical fecal immunochemical test (FIT) test every 2 years. Those positive are referred for colonoscopy. At the beginning of our program screening was decided to give priority to subjects aged 60–69 (about 70% of all FIT invitations). Aim of this study is to enquire incidental IBD diagnosis among BCSP.

Methods: Between Oct 2008 to May 2009 34119 FIT kits dispatched had been returned by 38.4% of men and 42.3% of women invited. Of the 13477 returning tests 835 had a positive test (6.4%). Responders to colonoscopy were 82.75% (691 colonscopies, 430 male, 261 female, medium age 62.39). We review data on this cohort of patients referred to screening colonoscopy in our centre to determine the incidental diagnosis of inflammatory bowel disease

Results: During investigations, among different incidental findings (haemorrhoids, diverticulosis, etc), only 1 case (ulcerative proctitis in a 61 years old male) of previously undetected IBD was found (0.15%). The patient was asymptomatic and diagnosis was confirmed by a second pathologist. Diagnosis of colorectal cancer was made in 68 cases (9.8%) while ≥1 colonic adenoma was present in 526 cases (76.1%).

Conclusion: Incidental diagnosis of IBD among our screened population is rare (0.15%) and considerably lower if compared to one analogous British study (published by abstract). The reasons could be explained by the relative initial older age of population studied (most of them older than 60 years old), the cumulative lower incidence of IBD in our region and the performance of fecal immunochemical test.