Patient's knowledge and fear about colorectal cancer risk in inflammatory bowel disease

ABSTRACT

Aim

To investigate patients' knowledge and fear about colorectal cancer (CRC) risk in inflammatory bowel disease (IBD) patients.

Methods

A 12-items self-administered questionnaire, developed after a careful literature review, was administered to all consecutive IBD patients treated with infliximab followed at Nancy University Hospital, France, between February and May 2012.

Results

100 patients (72 % with Crohn's disease [CD]) were included. Only 6% of patients spontaneously mentioned CRC risk as a main feature of IBD and 37% as a potential IBD complication. CRC was the most feared complication by 26% of patients (ulcerative colitis [UC] = 46% and CD = 18%, p < 0.01). Two thirds of patients knew that IBD increases CRC risk (UC = 82% and CD = 57%, p = 0.02). Main information's source was their gastroenterologist (52%). About the best screening method for CRC, 86% of respondents mentioned colonoscopy. Only 32% of patients knew that it has to be performed 10 years after diagnosis. In case of dysplasia, half of patients would not undergo colectomy (CD = 60% and UC = 29%, p < 0.01), mainly due to the fear of having a stoma. Only one quarter of UC patients were aware of the chemopreventive effect of 5-aminosalicylates on CRC risk.

Conclusions

Two thirds of IBD patients are aware of CRC risk. UC patients have a better knowledge of this risk and are more afraid of this complication. Our results underscore the need for therapeutic education about CRC in IBD patients.

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