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Inflammatory bowel disease II
PTU-117 Analysis of the incidental diagnosis of inflammatory bowel disease made during the Scottish Bowel Cancer Screening Programme
  1. M A Zahid1,
  2. C Noble1,
  3. C W Lees1,
  4. J Satsangi1,
  5. G Wilson2,
  6. A Lessells3
  1. 1Gastroenterology, Western General Hospital, Edinburgh, UK
  2. 2Colorectal Surgery, Western General Hospital, Edinburgh, UK
  3. 3Pathology, Western General Hospital, Edinburgh, UK

Abstract

Introduction The Scottish Bowel Screening Programme (SBSP) has been running in Scotland since March 2008 in patients aged between 50 and 74. The aim of this study was to quantify the number of new cases of inflammatory bowel disease (IBD) diagnosed as part of the SBSP in South East Scotland. The progression of these patients was also assessed.

Methods All the patients who had a bowel screening colonosocpy during the first 3 years of SBSP in South East Scotland were identified (screening population 800 000). Histologically confirmed cases of IBD were isolated and information like symptoms at the time of diagnosis, risk factors and initial treatment was collated. The severity of illness was retrospectively assessed using Harvey Bradshaw index and Mayo score for Crohn's disease (CD) and ulcerative colitis (UC) respectively. The patients' progress following diagnosis was also assessed.

Results 51 (1.4%) patients with IBD were diagnosed out of total 3655 procedures performed between June 2008 and April 2011. Of these, 12 (0.3%) patients had previous diagnosis of IBD and were excluded from study. In patients with a new diagnosis of IBD (n=39), significantly more males 30 (77%), with a mean age of 63 at diagnosis, were diagnosed with IBD than females (9–23%), (p<0.001), mean age of 67. 12 (30%) Patients were diagnosed with CD, 16 (41%) had UC and 11 (28.2%) had IBD unclassified (IBDU). The disease location is shown in Abstract PTU-117 table 1. 26 (67%) patients were symptomatic at the time of diagnosis with a mean Mayo score of 2.4 for UC and a mean Harvey Bradshaw score of 1.4 for CD group. 34 (87%) of patients were in remission in the follow-up period of 6 to 30 months. 9 (23%) had no treatment, 19 (48.4%) had oral or topical mesalazine, 4 (10%) had oral steroids while 3 (7.6%) patients required both oral steroids and mesalazine. Five patients were unresponsive to initial therapy (2-CD, 1-UC, 2-IBDU). Among these, three patients required Azathioprine, two had steroids and one required methotrexate after developing inflammatory arthritis.

Conclusion In this cohort of 3655 patients, IBD was diagnosed in 1.1% of patients. This is in line with published data.1 There was a preponderance of male patients. When assessed the majority of patients had previous symptoms and following diagnosis their IBD followed a benign course.

Abstract PTU-117 Table 1

Site of involvement on colonoscopy

Competing interests None declared.

Reference 1. Louis-Auguste J, Cohen P, Martin J, et al. New diagnoses of inflammatory bowel disease during bowel cancer screening colonoscopy. Gut 2011;60:A217.

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