title: Colon cancer surveillance in inflammatory bowel disease: unclear gain but no psychological pain?
abstract: BACKGROUND
  Surveillance for colorectal neoplasia in inflammatory bowel disease (IBD) is widely practised despite a lack of convincing mortality reduction. The psychological impact of this approach is largely unexplored.
  
  
  OBJECTIVE
  To examine psychological well-being among IBD subjects undergoing colonoscopic surveillance for colorectal cancer (CRC).
  
  
  METHODS
  A cross-sectional study was performed by interrogating an IBD database for subjects currently enrolled in colonoscopic surveillance programmes. Identified surveillance subjects were age- and gender-matched with IBD control subjects not meeting surveillance criteria. Subjects were mailed a questionnaire including demographic details, the Short Form 36 (SF-36) survey to assess quality of life, the Spielberger State-Trait Personality Inventory, the Multidimensional Health Locus of Control, and a Risk Perception Questionnaire.
  
  
  RESULTS
  One hundred and thirty-nine of 286 (49%) subjects responded, 53% male, 46% Crohn disease. Fifty-six per cent respondents were in the surveillance group. Surveillance subjects were older (55.4 vs 51.1 years; P = .048) with longer disease duration, but otherwise had comparable demographics with controls. Overall, quality of life was not significantly different between cohorts (mean SF-36 63.82 vs 65.48; P = 0.70). Groups did not differ on any locus of control classification (P = 0.52), nor was there any difference between mean scores on 'state' subscales of the Spielberger State-Trait Personality Inventory: anxiety (P = 0.91), curiosity (P = 0.12), anger (P = 0.81) or depression (P = 0.70). Both groups grossly overestimated their perceived lifetime risk of CRC at 50%, with no difference between surveillance and control subjects (P = 1.0).
  
  
  CONCLUSIONS
  Enrolment in colonoscopic colon cancer surveillance does not appear to impair psychological well-being in individuals with IBD despite longer disease duration. IBD patients overestimate their risk of CRC.
authors.affiliation: Flinders University of South Australia, Adelaide, South Australia, Australia; Department of Gastroenterology, Flinders Medical Centre, Adelaide, South Australia, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Mountifield
authors.forename: P
authors.initials: P
authors.lastname: Bampton
authors.forename: R
authors.initials: R
authors.lastname: Prosser
authors.forename: A
authors.initials: A
authors.lastname: Mikocka-Walus
authors.forename: J M
authors.initials: JM
authors.lastname: Andrews
mesh_terms: D000223:Adaptation, Psychological; D001315:Australia / Q000453:epidemiology; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000523:psychology; D003113:Colonoscopy / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011159:Population Surveillance; D011788:Quality of Life; D012107:Research Design; D011795:Surveys and Questionnaires
keywords: CRC; anxiety; cancer surveillance; inflammatory bowel disease; risk perception