P757 Prevalence of inflammatory bowel disease (IBD) in a colorectal cancer population screening program
C. Bezzio*1, I. Arena1, C. Della Corte1, M. Devani1, G. Manes1, B. Omazzi1, S. Saibeni1
1ASST Rhodense, Rho, Italy
in general, IBD are diagnosed in subjects with gastrointestinal symptoms, despite this a diagnostic delay is often observed. However IBD may also be present in asymptomatic subjects. In these cases, diagnosis may be further delayed, incidentally done or missed.
we analysed an electronic database of a regional colorectal cancer population screening program offered to subjects from 50 to 70 years old with faecal occult blood. From 1 September 2013 to 31 August 2018, among subjects who underwent colonoscopy in a single hospital, we identified subjects with endoscopic findings suggestive of IBD. Of these, we retrieved histological findings as well as information on other examinations and possible therapeutic decisions.
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%). Of these, 3 already underwent to colonoscopy in the context of the same program and 1 showed familiarity for IBD. Seven 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.
prevalence of IBD in a colorectal cancer population screening program is 0.5%. IBD diagnosis can be missed in asymptomatic subjects, but only 1 out of 3 subjects with endoscopic findings suggestive of IBD is eventually diagnosed as affected by CD or UC.