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P130 Delay in diagnosis of inflammatory bowel diseases and associated factors since the 1980s

P. Giannelis1, G. Michalopoulos*1, S. Vrakas1, K. Makris1, C. Kapizioni1, P. Kourkoulis1, G. Koutoufaris1, K. Milioni1, V. Xourgias1

1Tzaneion General Hospital of Piraeus, Gastroenterology, Piraeus, Greece

Background

There is an increase in IBD (Crohn’s disease-CD and ulcerative colitis-UC) diagnosis during the last decades. Also the importance of early treatment commencement has been highlighted by several studies. The aim of the present study was to investigate whether there is a change in the time delay between symptom initiation and diagnosis nowadays in comparison to the past and to search for possible associated factors.

Methods

The medical records of patients of the outpatient IBD clinic of ‘Tzaneion’ General Hospital from the beginning of patient recording up to present were revised and were classified in 4 time periods (1980–1989, 1990–1999, 2000–2009 and 2010 until 2018). Data regarding time of initiation of symptoms and time of diagnosis of IBD as well as data regarding age at diagnosis (according to Montreal classification), gender, disease type (ulcerative colitis-UC and Crohn’s disease-CD) and educational level were collected excluding patients with missing data.

Results

In total, 483 patients in total (UC: 240, CD 243) were studied. The results regarding delay of diagnosis from initiation of symptoms are shown in Table 1.

Decades1980–19891990–19992000–20092010–2017p-value
Delay (months)8.55 ± 14.711.2 ± 21.29.3 ± 15.19.1 ± 15.90.74
UC10.8 ± 19.16.3 ± 12.47.7 ± 12.76.7 ± 14.30.61
CD5.6 ± 4.917.6 ± 27.910.5 ± 16.711.8 ± 17.30.1

The results regarding delay of diagnosis from initiation of symptoms and the aforementioned factors are shown in Table 2.

Delay (months)p-value
Men vs. women7.8 ± 14.9 vs. 12 ± 18.80.021
UC vs. CD7.3 ± 13.6 vs. 11.8 ± 19.10.003
Education (primary vs. secondary vs. tertiary)8.6 ± 16.1 vs. 9 ± 14.6 vs. 12.3 ± 24.10.31
Age (≤16 vs. 17–40 vs. ≥41)7.8 ± 13.4 vs. 10 ± 17 vs. 9.1 ± 17.20.71

Conclusion

According to the results, it seems that despite the constantly increasing interest in IBD and the evolution of diagnostic means, there has been no improvement as far as the delay between initiation of symptoms and diagnosis is concerned. The results are similar for both UC and CD. As for associated factors it was found that male patients and patients with UC are diagnosed earlier compared with females and patients with CD, whereas age at time of diagnosis and educational level are not associated with the time delay.