Quiz Ref ID Colorectal cancer (CRC) is the third most common type of cancer in men and the second most common in women worldwide.¹ Early detection of CRC through widely applied screening programs has proven to be effective in reduction of cancer-related mortality. Guidelines for average-risk populations support use of several screening modalities, including colonoscopy, fecal occult blood tests or computed tomography colonography. However, recommendations for increased-risk individuals are more aggressive and support only use of colonoscopy. Such a strategy is associated with higher cost, lower adherence, and higher risk for rare, but serious, complications.^2-6

Summary: Background: Patient‐reported outcomes are important in the assessment of efficacy of intervention for ulcerative colitis (UC).Aim: To compare the impact of interventions for moderate‐to‐severe UC on health‐related quality of life (HRQL).Methods: We searched Medline, Embase, CENTRAL and grey literature sources through October 2017. We included randomised controlled trials (RCTs) that compared infliximab, adalimumab, golimumab, vedolizumab or tofacitinib to each other or placebo. Outcomes included the change in quality of life scores and the proportion of patients with improvement in quality of life. We performed random‐effect pairwise and network meta‐analysis. We assessed confidence in estimates using the CINeMA (Confidence in Network Meta‐Analysis) framework.Results: Fourteen RCTs assessed HRQL using the Inflammatory Bowel Disease Questionnaire (IBDQ) (14 trials), the Short Form questionnaire‐36 (SF‐36) (seven trials) or the European Quality of Life‐5 Dimensions questionnaire (EQ‐5D) (three trials). At induction (13 trials), low to very low confidence evidence suggested that all agents significantly improved both generic and disease‐specific HRQL scores compared to placebo. However, only infliximab (MD 18.58; 95% CI 13.19‐23.97) and vedolizumab (MD 18.00; 95% CI 11.08‐24.92) showed clinically meaningful improvement in IBDQ score. Differences among individual interventions were imprecise. For maintenance (four trials), very low confidence evidence suggested that vedolizumab, tofacitinib and adalimumab maintained improvement in HRQL.Conclusions: Induction treatment with infliximab, adalimumab, golimumab, vedolizumab or tofacitinib improves quality of life compared to placebo. Evidence on maintenance therapy is sparse and uncertain. Head‐to‐head comparisons could enhance confidence in conclusions about differences between drugs in terms of HRQL.

Background: The Inflammatory Bowel Disease-Disk (IBD-Disk) is a physician-administered tool that evaluates the functional status of patients with Inflammatory Bowel Disease (IBD). The aim of our study was to validate the content of the IBD-Disk in a Greek cohort of IBD patients. Methods: Two questionnaires [the IBD Disk and the IBD-Disability Index (IBD-DI)] were translated into Greek and administered to IBD patients at baseline visit, after 4 weeks and 6 months. Validation of the IBD Disk included measuring of concurrent validity, reproducibility, and internal consistency. Results: A total of 300 patients were included at baseline and 269 at follow-up. There was a good correlation between the total scores of the IBD-Disk and IBD-DI at baseline (Pearson correlation 0.87, p < 0.001). Reproducibility of the total IBD-Disk score was very good [intra-class correlation coefficient (ICC), 95% confidence interval (CI) 0.89 (0.86–0.91)]. Cronbach’s coefficient alpha for all items achieved 0.90 (95%CI 0.88–0.92), demonstrating a very good homogeneity of the IBD-Disk items. Female gender and extraintestinal manifestations were significantly associated with a higher IBD-Disk total score. Conclusions: The Greek version of the IBD-Disk proved to be a reliable and valid tool in detecting and assessing IBD-related disability in a Greek cohort of IBD patients.

Inflammatory bowel disease (IBD) plays an important role in patients’ psychological and sexual wellbeing, thus affecting severely their quality of life. We aimed to measure the incidence of psychosexual malfunction in Greek IBD patients as opposed to healthy controls. IBD patients, aged 18–65 were asked to participate during their visit in our outpatient ward. Volunteers participated as controls after sex, age, BMI and smoking habits matching. Anxiety and depression were evaluated with the Hamilton Anxiety Rating Scale (HAM-A) and Zung Self Rated Depression scale accordingly. Impaired sexual function was measured using the International Index of Erectile Function (IIEF) for men and the Brief Index of Sexual Function in Women (BISFW) for the female patients. Individuals identified as single were excluded from completing the latter questionnaire. A total of 153 patients (48.4% female, median age 44 y/o), 101 (66.1%) with Crohn’s disease (CD), 52 (33.9%) with ulcerative colitis (UC) and 43 volunteers (67.4% female, median age 40 y/o) participated in the study. Overall anxiety was recorded in 32.7% of the patients and in 14% of the healthy controls (OR = 2.99, 95% CI = 1.2–7.5, p = 0.02). Depression was recorded in 10.5% of the patients and in 4.7% of controls (p = 0.37). Sexual dysfunction was recorded in 42.7% of the patients and in 10.5% of the healthy controls (OR = 6.3, 95% CI = 2.1–18.9, p < 0.001). 22.8% of male IBD patients had anxiety (p = 0.06), 8.9% depression (p = 0.58) and 33.3% erectile dysfunction (p = 0.9). 41.9% of the female patients had anxiety (p = 0.04), 12.2% depression (p = 0.78) and 54.1% sexual dysfunction (p < 0.001). Anxiety was recorded in 36.6% of the CD patients and in 25% of the UC patients (p = 0.14). Depression for CD and UC was 8.9% and 13.5%, respectively (p = 0.38). Sexual dysfunction for CD patients was 44.8% and for UC patients 38.6% (p = 0.49). In patients with perianal disease anxiety was measured at 25.7% (p = 0.07), depression at 8.6% (p = 0.89) and sexual dysfunction at 33.3% (p = 0.10). The duration of disease did not affect significantly any of the aspects measured. IBD patients tend to have higher levels of anxiety and impaired sexual function compared with the healthy controls even with satisfactory control of their disease. Further studies clarifying the factors associated with their malfunction, as well as therapeutic interventions in order to improve the quality of life of the patients, are needed.