The first two authors contributed equally.
Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease†
Version of Record online: 20 APR 2011
Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 18, Issue 3, pages 496–505, March 2012
How to Cite
Vavricka, S. R., Spigaglia, S. M., Rogler, G., Pittet, V., Michetti, P., Felley, C., Mottet, C., Braegger, C. P., Rogler, D., Straumann, A., Bauerfeind, P., Fried, M., Schoepfer, A. M. and the Swiss IBD Cohort Study Group (2012), Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease. Inflamm Bowel Dis, 18: 496–505. doi: 10.1002/ibd.21719
Supported by research grants from the Swiss National Science Foundation (320000-114009/1 to S.R.V., 3347CO-108792 Swiss IBD Cohort) and a grant of the Zurich Centre of Integrative Human Physiology.
- Issue online: 13 FEB 2012
- Version of Record online: 20 APR 2011
- Manuscript Accepted: 2 MAR 2011
- Manuscript Received: 27 FEB 2011
- diagnostic delay;
- risk factors
The diagnosis of inflammatory bowel disease (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), continues to present difficulties due to unspecific symptoms and limited test accuracies. We aimed to determine the diagnostic delay (time from first symptoms to IBD diagnosis) and to identify associated risk factors.
A total of 1591 IBD patients (932 CD, 625 UC, 34 indeterminate colitis) from the Swiss IBD cohort study (SIBDCS) were evaluated. The SIBDCS collects data on a large sample of IBD patients from hospitals and private practice across Switzerland through physician and patient questionnaires. The primary outcome measure was diagnostic delay.
Diagnostic delay in CD patients was significantly longer compared to UC patients (median 9 versus 4 months, P < 0.001). Seventy-five percent of CD patients were diagnosed within 24 months compared to 12 months for UC and 6 months for IC patients. Multivariate logistic regression identified age <40 years at diagnosis (odds ratio [OR] 2.15, P = 0.010) and ileal disease (OR 1.69, P = 0.025) as independent risk factors for long diagnostic delay in CD (>24 months). In UC patients, nonsteroidal antiinflammatory drug (NSAID intake (OR 1.75, P = 0.093) and male gender (OR 0.59, P = 0.079) were associated with long diagnostic delay (>12 months).
Whereas the median delay for diagnosing CD, UC, and IC seems to be acceptable, there exists a long delay in a considerable proportion of CD patients. More public awareness work needs to be done in order to reduce patient and doctor delays in this target population. (Inflamm Bowel Dis 2012;)