Asymptomatic Inflammatory Bowel Disease Diagnosed During Colorectal Cancer Population Screening in Catalonia: Characteristics and Natural History

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We thank Michael Maudsley for his help with the English. To all my department colleagues, Laura, Belen, Quique, Luigi, Albert, who have supported me and allowed me to work and focus on this project.

Impact on the Sustainable Development Goals (SDGs)

Analysis of institutional authors

Brunet-Mas, EduardAuthorCaballol, BertaAuthor

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Article

Publicated to:Clinical And Translational Gastroenterology. 16 (2): e00740- - 2025-02-01 16(2), DOI: 10.14309/ctg.0000000000000740

Authors: Brunet-Mas, Eduard; Selva, Anna; Bas-Cutrina, Francesc; Brujats, Anna; Caballol, Berta; Font, Rebeca; Gomez, Barbara; Gonzalez-Munosa, Carlos; Busquets, David; Monfort, David; Vera, Diana Patricia; Maristany, Elisabet; Cirera, Gemma; Torres, Gisela; Castro-Poceiro, Jesus; Lopez, Joel; Gonzalez-Gonzalez, Laura; Marquez-Mosquera, Lucia; Gallach, Marta; Esteve, Maria; Tremosa, Gemma; Torra, Sandra; Robles-Alonso, Virginia; Garcia-Iglesias, Pilar; Rodriguez-Lago, Iago; Calvet, Xavier

Affiliations

Bellvitge Biomed Res Inst IDIBELL, Barcelona, Spain - Author

Catalan Canc Plan, Dept Hlth, Barcelona, Spain - Author

Consorci Sanitari Terrassa, Gastroenterol Dept, Terrassa, Spain - Author

Hosp Althaia, Gastroenterol Dept, Manresa, Spain - Author

Hosp Arnau Vilanova, Gastroenterol Dept, Lleida, Spain - Author

Hosp Bellvitge Princeps Espanya, Gastroenterol Dept, Barcelona, Spain - Author

Hosp Berga Salut Catalunya Cent, Gastroenterol Dept, Berga, Spain - Author

Hosp Clin Barcelona, Inst Invest Biomed Pi Sunyer IDIBAPS, Gastroenterol Dept, CIBEREHD, Barcelona, Spain - Author

Hosp Comarcal Alt Penedes, Gastroenterol Dept, Barcelona, Spain - Author

Hosp Gen Granollers, Gastroenterol Dept, Granollers, Spain - Author

Hosp Germans Tries & Pujol, Gastroenterol Dept, Badalona, Spain - Author

Hosp Igualada, Gastroenterol Dept, Igualada, Spain - Author

Hosp Mar, Gastroenterol Dept, Barcelona, Spain - Author

Hosp Martorell, Gastroenterol Dept, Martorell, Spain - Author

Hosp Mataro, Gastroenterol Dept, Mataro, Spain - Author

Hosp Moises Broggi St Joan Despi, Gastroenterol Dept, Barcelona, Spain - Author

Hosp Santa Creu & St Pau Barcelona, Gastroenterol Dept, Barcelona, Spain - Author

Hosp Univ Girona Dr J Trueta, Gastroenterol Dept, Girona, Spain - Author

Hosp Univ Joan XXIII, Gastroenterol Dept, Tarragona, Spain - Author

Hosp Univ Mutua Terrassa, Gastroenterol Dept, Terrassa, Spain - Author

Hosp Univ Vic, Gastroenterol Dept, Vic, Spain - Author

Hosp Valle De Hebron, Gastroenterol Dept, Barcelona, Spain - Author

Inst Salud Carlos III, CIBER Epidemiol & Salud Publ, Madrid, Spain - Author

Inst Salud Carlos III, CIBERehd, Madrid, Spain - Author

Parc Sanitari St Joan Deu, Gastroenterol Dept, Barcelona, Spain - Author

Parc Tauli Hosp Univ, Inst Invest & Innovacio Parc Tauli I3PT CERCA, Gastroenterl Dept, Sabadell, Spain - Author

Univ Autonoma Barcelona, Dept Med, Barcelona, Spain - Author

Univ Autonoma Barcelona, Dept Pediat Obstet Gynecol & Prevent Med, Barcelona, Spain - Author

Univ Autonoma Barcelona, Med Dept, Bellaterra, Spain - Author

Univ Autonoma Barcelona, Parc Tauli Hosp Univ, Inst Invest & Innovacio Parc Tauli I3PT CERCA, Clin Epidemiol & Canc Screening, Barcelona, Spain - Author

Univ Deusto, Hosp Univ Galdakao, Biobizkaia Hlth Res Inst, Gastroenterol Dept, Galdakao, Spain - Author

Abstract

INTRODUCTION:Inflammatory bowel disease (IBD) is usually diagnosed when symptomatic. Prognosis and evolution of preclinical IBD is largely unknown. However, colorectal cancer screening programs (CRCSP) detect a subset of patients with IBD with no symptoms. The aim of this study was to describe the natural history of asymptomatic IBD diagnosed through CRCSP. METHODS:An observational, longitudinal, and retrospective study was performed at 22 centers in Catalonia between January 2010 and December 2019 including patients with asymptomatic IBD detected in the CRCSP. Demographic data and IBD characteristics, evolution, and treatment were recorded. Descriptive statistics and Kaplan-Meier analysis were used for the analysis. Data were given separately for IBD, Crohn's disease (CD), ulcerative colitis (UC), and IBD unclassified (IBDU). RESULTS:One hundred eighty-eight patients were included: 103 UC (54.8%), 60 CD (31.9%), and 25 IBDU (13.3%). Sixty-six (35.1%) were women, and the average age was 59.9 +/- 5.9 years. Sixty-four patients (34.0%) developed symptoms after a median follow-up of 35.6 months. Diarrhea was the most frequent symptom for CD and IBDU (25.4% and 11.5%, respectively) and blood in stools for UC (21.4%). The median time to first symptom was 11.6 months. Treatment was prescribed in 135 patients (72.2%); mesalazine was the most prescribed drug (123 patients; 65.4%). Thirteen patients (6.9%) required biological treatment. None underwent surgery. DISCUSSION:Around one-third of asymptomatic patients with IBD developed symptoms after a medium follow-up of 3 years. Only 6.9% required biological treatment, and none required surgery. Overall, prognosis of asymptomatic IBD seems better.

Keywords

AsymptomatiCrohn's diseaseEpidemiologyGood health and well-beingInflammatory bowel diseaseManagementMarkerPrevalenceProgramRiskScreeningUlcerative colitis

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Clinical And Translational Gastroenterology due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2025, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category .

Impact and social visibility

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Brunet Serra, Mercedes) .