OP23 Asymptomatic inflammatory bowel disease diagnosed during the colorectal cancer population screening in Catalonia

Brunet, E.(1,2)*;Selva, A.(3,4);Bas-Cutrina, F.(5);Brujats, A.(6,7);Caballol, B.(8);Gomez, B.(9);Gonzalez, C.(7);Busquets, D.(10);Monfort, D.(11);Vera, D.P.(12);Maristany, E.(13);Cirera, G.(14);Torres, G.(15);Castro-Poceiro, J.(16);Lopez, J.(17);Gonzalez-Gonzalez, L.(18);Marquez-Mosquera, L.(19);Gallach, M.(20);Esteve, M.(21);Tremosa, G.(22);Torra, S.(23);Robles, V.(24);Rodríguez-Lago, I.(25);Calvet, X.(2,26,27);

(1)Hospital Parc Taulí, Gastroenterology department, Sabadell, Spain;(2)Instituto de Salud Carlos III, CIBERehd, Madrid, Spain;(3)Hospital Universitari Parc Taulí, Clinical epidemiology and cancer screening, Sabadell, Spain;(4)Universitat Autònoma de Barcelona, Department of Pediatrics- Obstetrics- Gynecology and Preventive Medicine, Bellaterra, Spain;(5)Hospital General de Granollers, Gastroenterology department, Granollers, Spain;(6)Hospital de Berga - Salut Catalunya Central, Gastroenterology department, Berga, Spain;(7)Hospital de la Santa Creu i Sant Pau de Barcelona, Gastroenterology department, Barcelona, Spain;(8)Hospital Clínic de Barcelona, Gastroenterology department, Barcelona, Spain;(9)Hospital de Mataró, Gastroenterology department, Mataró, Spain;(10)Hospital Universitari de Girona Dr. J. Trueta, Gastroenterology department, Girona, Spain;(11)Consorci Sanitari de Terrassa, Gastroenterology department, Terrassa, Spain;(12)Hospital de Martorell, Gastroenterology department, Martorell, Spain;(13)Hospital de Bellvitge, Gastroenterology department, Bellvitge, Spain;(14)Hospital Althaia, Gastroenterology department, Manresa, Spain;(15)Hospital Universitari Arnau de Vilanova, Gastroenterology department, Lleida, Spain;(16)Sant Joan Despí Moisès Broggi, Gastroenterology department, Barcelona, Spain;(17)Hospital Universitari Joan XXIII, Gastroenterology department, Tarragona, Spain;(18)Hospital Germans Tries I Pujol, Gastroenterology department, Badalona, Spain;(19)Hospital del Mar, Gastroenterology department, Barcelona, Spain;(20)Hospital Universitari de Vic, Gastroenterology department, Vic, Spain;(21)Hospital Mutua de Terrassa, Gastroenterology department, Terrassa, Spain;(22)Hospital Comarcal de l’Alt Penedès, Gastroenterology department, Barcelona, Spain;(23)Parc Sanitari Sant Joan de Déu, Gastroenterology department, Barcelona, Spain;(24)Hospital Vall d’Hebron, Gastroenterology department, Barcelona, Spain;(25)Hospital de Galdakao- Galdakao, Gastroenterology department, Vizcaya, Spain;(26)Hospital Universitari Parc Taulí, Gastroenterology department, Sabadell, Spain;(27)Universitat Autònoma de Barcelona, Medicine departament, Bellaterra, Spain;


Background: It has been postulated that early treatment of inflammatory bowel disease (IBD) is associated with a better long-term response. In Catalonia, the early detection program for colorectal cancer (EDPCRC) has been active since 2010, and was extended to the entire Catalan territory in 2015. The aim of this study is to describe the natural history of IBD asymptomatic diagnosed through the EDPCRC in Catalonia.


Methods: Observational, longitudinal and retrospective study of patients with IBD detected in the EDPCRC with a positive faecal immunological test in 21 centers in Catalonia between 2010 and 2019. Data was collected from the clinical histories.


Results: 237 patients were identified; 35 patients had symptoms before endoscopy and were excluded from the study, finally 200 patients were diagnosed with asymptomatic IBD during the EDPCRC; 109 ulcerative colitis (54.5%), 63 Crohn's disease (31.5%) and 28 unclassifiable colitis (14%). 35.5% were women (n=71) with an average age of 60 years (range 49-79). Of the asymptomatic, 40.5% developed symptoms (n=81), being diarrhea the most frequent (n=45; 55.6%). The median time to first symptom was 368 days. Treatment was prescribed in 74.5% (n=149) of the patients. Mesalazine was the most frequently prescribed drug (n=130). The main reason for prescribing it was endoscopic activity (n=107), followed by the appearance of symptoms (n=39) and the biochemical activity (n=9). Only 19 patients (9.5%) required biological treatment (5 infliximab, 10 adalimumab, 2 vedolizumab and 2 ustekinumab). 4 patients (2%) required surgery.


Conclusion: Less than half of patients diagnosed with IBD at a preclinical stage develop symptoms after the first year of follow-up. Only 9.5% require biological treatment and 2% surgery. Three-quarters of patients are prescribed treatment; the most used was mesalazine.