N04 Knowledge, attitude and perception of inflammatory bowel disease patients towards colorectal cancer risk, its management and the role of healthcare providers: a cross-sectional study in the UK
F. Khan, W. Czuber-Dochan, C. Norton
King’s College London, Adult Nursing, London, UK
Background
Inflammatory bowel disease (IBD) increases the risk of colorectal cancer (CRC) and requires specialised cancer risk management. Although literature exists on general disease-related knowledge in IBD patients, limited studies have assessed IBD patients’ knowledge of CRC risk and its management. Consequently, patient perception of the role of a healthcare provider (HCP) in patient education of CRC risk and their attitude towards recommended risk management has not been assessed in UK IBD patients.
Methods
We conducted a cross-sectional online survey with IBD patients recruited via charity sources from April-July 2019. Adult patients (>18 years) with a confirmed diagnosis of IBD for 2 years and adequate command of English language were included. A self-designed and piloted questionnaire with open and closed-ended questions was used. Closed-ended data were analysed using descriptive statistics and open-ended responses were analysed using content analysis. Fischer’s exact test and bivariate logistic regression were used to test for association between knowledge and patient demographics.
Results
92 participants, including 52.5% CD and 67.5% females, responded. 88% knew that IBD increases CRC risk. The mean fear of CRC risk (0–10 visual analogue scale) was 6.37 (SD ± 2.8). One-fifth were aware of colonoscopy as the best screening tool; 88% were unaware of screening initiation time. 90% would agree to their doctor’s recommendation of colonoscopy to ensure early cancer diagnosis and treatment. For dysplasia with 10% risk of CRC, 46.7% would not agree to colectomy mainly due to 10% risk of CRC not being high enough to undergo surgery. Forty-eight per cent of participants said that they never had a discussion about increased CRC risk in IBD with their doctor. Almost two-thirds were not informed about the role of screening/surveillance in cancer. Two-thirds were satisfied with the information provided by their HCP. Overall, patients desired more information about their individualised cancer risk and services available for managing the increased risk.
Conclusion
IBD patients are well informed about IBD-associated CRC risk, feared this risk greatly but were poorly aware of screening initiation time. HCP’s role in cancer knowledge dissemination was sub-optimal and patients desired more knowledge. We need deeper understanding of patients’ educational needs related to CRC.