Abstract Background Diagnostic delay determines more aggressive colorectal cancer (CRC) features. The SARS-CoV-2 pandemic represented an example supporting this assumption, as reduced access to screening resulted in an increase in CRC diagnosed at an advanced stage. Inflammatory Bowel Disease (IBD) patients were similarly affected. This study aims to address the features of CRC in IBD and to measure the impact of pandemic on this specific group. Methods In this multicentre, nationwide study, a retrospective analysis was performed of all consecutive patients who underwent surgery for CRC between January 1, 2018, and December 31, 2021. The main outcome was to evaluate the features of IBD-CRC compared to the general population. Secondary endpoints were differences between Crohn’s disease (CD) and ulcerative colitis (UC), differences in CRC-IBD between the pre-pandemic and pandemic period, and presence of independent risk factors for aggressive biology in the IBD-CRC. Results A total of 17,922 patients from 81 Italian centres were included, of whom 110 were affected by UC and 39 by CD. Over the entire period, higher rates of advanced stage at diagnosis (57.7% vs. 48.3; p = 0.034) and aggressive biology (79.7% vs. 70.0%; p = 0.013) were observed in IBD-CRC vs sporadic-CRC. CD-CRC showed higher rates of aggressive biology (92.1% vs. 75.5%; p = 0.051) and palliative surgery (17.9% vs. 5.5%; p = 0.043) versus UC-CRC. In IBD patients the pandemic period was associated with more palliative procedures (15.4% vs. 3.6%; p = 0.034). Age, histologic type, advanced stage, T4, stenotic lesion, right location, and COVID period were independently associated with aggressive biology in IBD-CRC (Table 1). Conclusion IBD-CRC had more advanced and more aggressive biology compared with sporadic-CRC. Similar to sporadic CRC, the pandemic had negatively impacted IBD-CRC. References: Rottoli M, Gori A, Pellino G, Flacco ME, Martellucci C, Spinelli A, Poggioli G; COVID–Colorectal Cancer (CRC) Study Group. Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy. JAMA Netw Open. 2022 Nov 1;5(11):e2243119. doi: 10.1001/jamanetworkopen.2022.43119 Gordon H, et al. ECCO Guidelines on Inflammatory Bowel Disease and Malignancies. J Crohns Colitis. 2023 Jun 16;17(6):827-854 Conflict of interest: Prof. Dr. Pellino, Gianluca: No conflict of interest Selvaggi, Lucio: No conflict of interest Calini, Giacomo: None Cardelli, Stefano: No conflict of interest Violante, Tommaso: No conflict of interest Soriano, Alessandra: No conflict of interest Fordellone, Mario: No conflict of interest Gori, Alice: No conflict of interest Selvaggi, Francesco: No conflict of interest Spinelli, Antonino: Personal Fees: Stryker, Johnson&Johnson, Arthrex Poggioli, Gilberto: No conflict of interest Rottoli, Matteo: No conflict of interest
Pellino et al. (Thu,) studied this question.