Prevalence and clinical profile of inflammatory bowel disease patients with small bowel cancer: A retrospective analysis of National Inpatient Sample data.

Abstract

484 Background: Small bowel cancer (SBC) accounts for around 3% of all gastrointestinal malignancies, with inflammatory bowel disease(IBD) recognized as a risk factor. Our study aims to evaluate the IBD prevalence in SBC patients, annual trends, and associated demographics, comorbidities, and healthcare burden. Methods: Adults(≥18 years) with SBC were queried from the National Inpatient Sample(NIS 2016-2022). The presence of IBD was further identified via prevalidated ICD-10 codes. We estimated the prevalence of IBD among SBC patients along with the yearly trend. Baseline patient demography and comorbidities were compared among both IBD and non-IBD cohorts. All analyses were performed via STATA 18.0, adjusting for the stratification, cluster, and weight of the NIS. Results: We found 67345 SBC patients which included 2360 cases(3.5%) of IBD, of which 83.47% had Crohn’s disease (CD) and 16.53% had ulcerative colitis (UC). The highest annual prevalence was noted in 2019 (4.21%), with a nadir in 2021 (2.9%). Yearly trends fluctuated as illustrated in Table 1 and were not statistically significant (ptrend = 0.229). IBD patients were younger (mean age 62.37 vs 66.81 years, p = <0.01), with fewer patients having preexisting hypertension (HTN) (43.43% vs 59.78%, p = <0.01), diabetes (15.89% vs 26.23%, p = <0.01), dyslipidemia (20.34% vs 36.37%), obesity (6.36% vs 10.56%), peptic ulcer disease (PUD) (0.636% vs 3.93%), long term aspirin use (5.09% vs 9.22%), congestive heart failure (CHF) (6.99% vs 11.53%), alcohol use (0.85% vs 2.39%), (p<0.05 throughout). The history of pulmonary embolism or thromboembolism was higher among IBD patients (12.29% vs 8.13%, p = <0.01). Most patients were insured with Medicare (47.46% of IBD vs 57.51% of non-IBD cohort, p = <0.01) and racially classified as White (86.36% of IBD cohort vs 64.83% of non-IBD cohort). Socioeconomic differences were noted as a higher proportion of non-IBD patients belonged to the lowest income quartiles (27.02%), whereas a greater percentage of IBD cohorts belonged to 51-75th percentile(31.48%). Around 50.21% of IBD and 50.89% of non-IBD patients had metastasis(p = 0.781). An estimated 12.71% of IBD and 15.73% of non-IBD patients used palliative care(p=0.086). IBD patients had a longer stay(9.83 vs. 8.63 days, p = 0.016) but comparable mean hospital charge($137260 vs. $118985, p = 0.076) and all-cause in-hospital death (6.36% vs 5.55%, p = 0.449). Conclusions: IBD cohort comprised younger patients who had fewer comorbidities. Continued screening, monitoring, and education of IBD patients remains essential. Additionally, the socioeconomic disparities observed among non-IBD patients in our study warrant further investigation. Prevalence of IBD among small bowel cancer admissions. Year 2016 2017 2018 2019 2020 2021 2022 Prevalence of IBD cases(%) 3.56 2.93 4.14 4.21 3.35 2.90 3.47