patients age 50-59 years. Methods: We performed a retrospective registry study of all firsttime colonoscopies performed in patients between the ages of 40 to 59 years. Exclusioncriteria included having a family history of CRC, personal history of inflammatory boweldisease, weight loss or iron deficiency anemia as indication for colonoscopy, incompletecolonoscopy and poor bowel preparation (Aronchik= poor, sub-optimal or Ottawa =/ .10).Information obtained included demographics, BMI, as well as endoscopic and pathologicreports. The variables were analyzed using multivariate regression analysis. Results: A totalof 2,607 colonoscopies were included in the analysis (1,911 ages 50-59 and 696 ages 40-49). Sixty six percent (1252/1911) of patients with age 50-59 years and 61% (425/696) ofpatients with age 40-49 years had a BMI =/ . 25. The ADR for patients 40 to 49 and 50to 59 years were 16.3% and 27% respectively. Patients with a BMI =/ . 25 had an increasedADR only after the age of 50 years (20% vs. 29% in 50-59 years & 16.5% vs. 16.3% in 40to 49 years). On logistic regression analysis, a BMI =/ . 25 increased the risk for adenomadetection in patients age 50 to 59 years (OR 1.54 CI 1.19 to 1.99 / p=0.0009), but nodifference was noted in patients age 40 to 49 years (OR 0.92 CI 0.56 to 1.50 / p=0.74).Conclusion: Patients aged 50-59 with a BMI =/ . 25 have an increased risk for detectionof adenomas compared with patients with a BMI ,25. This risk was not appreciated inpopulation younger than 50 years.

Su1052

Rate of Colonoscopy Has Decreased in Patients With Diverticular Bleeding butthe Mortality Has Remained the Same: A Nationwide Analysis of Trends 2004-2008Muhammad Ali, Shahryar Ahmad, Nilay Kumar, Gagan Kumar, Kia Saeian

Introduction: Diverticular bleeding is a major cause of lower gastrointestinal bleeding (LGIB)and leads to morbidity and mortality among hospitalized patients. Colonoscopy can beperformed as a diagnostic as well a therapeutic procedure. If bleeding is uncontrolled, acolectomy may need to be performed. There is conflicting data on whether trends in theseprocedures have changed over time. With our study, we wanted to 1) identify proceduretrends in diverticular bleeding patients including colonoscopy and colectomy, 2) determineif this has had any impact on the mortality. Materials and Methods: Using NationwideInpatient Sample (NIS) from year 2004-2008, we identified patients admitted with a diverticu-lar bleed using appropriate ICD-9 codes. Among these patients, the rate of colonoscopy andcolectomy was determined using appropriate procedure codes. Mortality was also calculatedfor these admissions. Results: There was an overall decrease in the number of patientsadmitted with diverticular bleeding from 2004-2008. The rate of colonoscopy decreasedfrom 71.06% to 65.72% (p,0.001) among patients admitted with diverticular bleeding.The rate of colectomy stayed about the same from 3.55% to 3.40% (p=0.66) for thisgroup. Overall mortality remained unchanged (1.87%-1.84%) among patients admitted withdiverticulosis. On subgroup analysis, mortality remained statistically unchanged when lookedat those undergoing colectomy or colonoscopy separately (10.6%-9.8% and 1.18%-1.25%).Other demographical variables such as age groups, gender, insurance distribution anddischarge disposition remained the same over 2004-2008. Conclusion: In this nationallyrepresentative sample, we found that from 2004-2008, the rate of colonoscopy in patientsadmitted with diverticular bleeding has decreased but has not impacted the morality. Furtherstudies to characterize the factors involved are warranted.

Su1053

Prevalence of Functional Bowel Disorders and Faecal Incontinence in PrimaryHealth-Care Seekers: An Australian ExperienceKheng-Seong Ng, Natasha Nassar, Marc A. Gladman

Introduction: Functional bowel disorders (FBDs) and faecal incontinence (FI) are chronic anddebilitating disorders that represent significant management problems. Whilst informationregarding their prevalence in the community is available, there is a relative paucity of clinic-based studies, which may provide useful information in health-care seekers. Additionally,little is known about the prevalence of FBD based on the Rome III criteria or the severityof FI in Australian populations. Therefore, the aim of this study was to measure the prevalenceof FBDs and FI (and its severity) among Australian primary health-care seekers usingobjective, standardised criteria. Methods: A cross-sectional survey was conducted amongstprimary health-care seekers in Sydney, Australia. Participants were prospectively recruitedon a consecutive basis as they entered clinic waiting rooms and completed a self-administeredquestionnaire designed to diagnose FBDs (irritable bowel syndrome [IBS], constipation,functional bloating, and functional diarrhoea) using the Rome III criteria. Further, the severityof FI was assessed using the modified Wexner incontinence score. In addition to measuringdisease prevalence, data were modelled to identify associations with medical and surgicalhistories and health-care utilisation. Results: 396 of 596 subjects (66.4%) approached agreedto participate. Demographic and socio-economic characteristics of the participants werereflective of the general population of Sydney. IBS, constipation, functional bloating, andfunctional diarrhoea were diagnosed in 11.1%, 8.1%, 6.1%, and 1.5% of subjects, respec-tively. FI was present in 12.1% of subjects with the majority (93%) reporting mild to

S-387 AGA Abstracts

moderate incontinence (modified Wexner score ,17). Subjects with FI were 4 times morelikely to have had previous anal surgery (OR3.80, 95%CI 1.55-9.33), 4 times more likelyto have IBS (OR3.80, 95%CI 1.82-7.93), and 3 times more likely to have urinary incontinence(OR3.24, 95%CI 1.73-6.08). Previous obstetric trauma was not associated with FI (P=0.79).Subjects with IBS were 9 times more likely to have had a previous colonoscopy (OR9.32,95%CI 3.10-28.04), 3 times more likely to report anxiety or depression (OR3.42, 95%CI1.78-6.58), and 3 times more likely to have had a previous cholecystectomy (OR3.11,95%CI 1.16-8.37). Whilst there was a tendency for diabetic subjects to be constipated, thisassociation failed to reach significance (P=0.07). Conclusions: FI and FBDs appear to beprevalent conditions amongst Australian primary health-care seekers. Furthermore, the needsof affected patients would seem to be complex given their co-existing symptoms/conditions,suggesting that detailed assessment is required to adequately address their needs. Thesefindings have implications for health service planning and provision.

Su1054

Prevalent Round Stage Shift in the National Bowel Cancer ScreeningProgramme in Wales; Data From the First 3 Years in At a Single ScreeningCentreJoanna Hurley, John Green, A. B. Hawthorne, Jared Torkington, Sunil Dolwani

Introduction: Colorectal cancer screening is based on early detection of cancers and removalof premalignant polyps though this adenoma to carcinoma sequence is thought to progressover several years. The Bowel Screening Programme in Wales based on guaiac FOBt andcolonoscopy for individuals resting positive began roll-out in October 2008, with the aimof reducing mortality through cancer detection at an early stage. The aim of this studywas to investigate whether screen detected cancers in Cardiff and the Vale of Glamorgandemonstrated any shift in the stage of cancer during the first three years of screening (initialprevalent round). Methods: Data was collected prospectively to compare the staging ofcolorectal cancer diagnosed in the BCSP with cancers diagnosed in the non-screening popula-tion in the same geographical region from 1st October 2008 to 31st December 2011. Allinformation was cross checked with Cancer Registry data. Results: Screen detected cancerwas found in 69 individuals (44 male, 25 female), with a positive predictive value ofcolonoscopy (after positive FOB testing) of 8.7%. Complete clinical staging was availablefor all 69 individuals; two patients did not undergo surgical resection due to the presenceof metastases after radiological staging. There were 696 non-screening detected cancersduring the same time period. For the purposes of this analysis, polyp cancers (cancer thatwas removed by endoscopic means at the time of colonoscopy/flexible sigmoidoscopy) wereincluded in Duke's stage A, except for one polyp cancer that required subsequent surgicalresection and was staged as Duke's C1. The results are shown in table 1. Three-quarters ofcancers diagnosed in the BCSP were Dukes A or B, compared to 44.1% in the non-screeningpopulation. Of Duke's D cancers, only 2.8% were diagnosed through screening, with 27%diagnosed in the non screening population (p ,0.0001). Conclusion: This data stronglysupports significant stage shift of colorectal cancer even within the initial prevalent roundin this single Bowel Cancer Screening centre in Wales that the benefits of screening maybe demonstrable in outcomes at a relatively early stage of the program.Table 1. Stage of cancer diagnosed with comparable data from non-screening population

Su1055

Similar Clinical Characteristics of Familial and Sporadic Inflammatory BowelDiseaseSooK Hee Chung, Soo Jung Park, Lee Hye Sun, Jae Hee Cheon, Sung Pil Hong, Tae IlKim, Won Ho Kim

Background: Inflammatory bowel disease (IBD) is caused by complex interaction betweengenetic and environmental factors. In spite of several studies of familial IBD, we do not havesufficient information about the clinical characteristics in familial IBD. The aim of this studyis to investigate differences of clinical characteristics and disease courses between familialand sporadic IBD patients. Methods: We obtained clinical data on Crohn's disease (CD, 691cases) and ulcerative colitis (UC, 1113 cases) in Severance Hospital, Yonsei University Collegeof Medicine from Jan. 2005 to Feb. 2012. Seventeen patients (2.5%) with CD and 27 patients(2.4 %) with UC identified to have familial history of IBD. For each control case, 3 timesage- and sex-matched CD and UC patients who had no family history of IBD were randomlyselected based on the electronic medical data. We compared the clinical characteristics anddisease course of familial CD/UC patients with sporadic CD/UC patients, respectively. Results:There were no significant differences of age at diagnosis, age at symptom onset, main symptomat diagnosis (abdominal pain, diarrhea, weight loss, fever, abdominal mass, hematochezia),extraintestinal manifestation, location, behavior of disease disease activity, number of hospi-talization, number of operation, operation type, causes of operation and operation rate,number of relapse, medical treatment with 5-ASA, oral steroid, and azathioprine betweenfamilial and sporadic CD and familial and sporadic UC patients, respectively. Median (min-max) follow up peroids after diagnosis of familal CD patients and sporadic CD patients were84 (24-312) months and 36 (8-240) months, respectively (P=0.008). But there was nosignificant difference of follow up peroids after diagnosis of familial UC patients and sporadicUC patients. Familial CD patients more frequently used anti TNF agents than sporadic CDpatients (3/17, 17.6 % vs 0/21, 0 %, P=0.014). Longer follow up period of disease mightresult in more usage of anti-TNF antibody in familial CD patients than sporadic CD patients.

AG

AA

bst

ract

s