P-108 African Americans with Inflammatory Bowel Disease Undergo More Abdominal CT Scans than Caucasians

Abstract

BACKGROUND: Recent studies have suggested an increasing prevalence of inflammatory bowel disease among non-Caucasian ethnicities. Comparison of disease presentation, natural history and management among whites and nonwhites has shown that there may be differences in disease course and disease treatment as well as access to care among different ethnic groups. We sought to evaluate the frequency of abdominal imaging among African-Americans and Caucasians with inflammatory bowel disease. METHOD(S): A retrospective medical record review of inflammatory bowel disease patients managed at an urban university was performed using a multispecialty electronic health record. All patients with inflammatory bowel disease, age >=18, were included. There were no exclusion factors. Patient gender, disease type, and abdominal imaging studies during a 3.5 year period were obtained. Abdominal imaging included radiographs, CT scans, MRIs and ultrasounds. A database, maintaining patient confidentiality, was created. Statistical analysis was performed using unpaired t-test with significance set at P < 0.05. The study was approved by the university institutional review board. RESULT(S): Three hundred twenty-one medical records were reviewed. There were 139 Caucasian patients, 79 African American patients, 86 patients of unknown ethnicity, 8 Asian patients and 4 Hispanic patients. The mean age was 42 years. On average, patients of any ethnicity received 0.69 abdominal CT scans in the 3.5 year study period. African-Americans received almost 3 times as many total CT scans than Caucasians (1.823 CT scans versus 0.683 CT scans, respectively, P = 0.0012). Notably, African-American patients received more than twice as many abdominal CT scans as Caucasian patients (1.266 abdominal CT scans versus 0.532 scans respectively, P = 0.0059). There was no significant difference in the number of abdominal x-rays (P = 0.0600), abdominal ultrasounds (P = 0.3543) or abdominal MRIs (P = 0.8613) performed on African American and Caucasian patients. CONCLUSION(S): Individual patients with IBD receive a significant number of abdominal imaging studies and consequently significant exposure to radiation through radiographs and abdominal CT scans. This study revealed that African American patients with inflammatory bowel disease received more imaging, notably more CT scans, than their Caucasian counterparts. While questions regarding differences in disease severity and natural history among ethnic groups remain unresolved, it is important to be aware of the increased risk of cancer associated with radiation exposure in patients with inflammatory bowel disease. Judicious use of medical imaging in all patients is important in inflammatory bowel disease management.