Awareness of inflammatory bowel disease-associated colorectal cancer risk and its management in patients with inflammatory bowel disease: a systematic review.

Background: Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer (CRC). While several studies have explored patients' general knowledge of IBD, less is known about their awareness of CRC risk and its management. This systematic review aimed to synthesize the available evidence on IBD patients' awareness of CRC risk and its related management strategies. Methods: Medline, EMBASE, and PubMed databases were searched from inception to November 2023. All study designs and publication types were considered. Non-English studies and those assessing only general IBD knowledge were excluded. The appraisal tool for cross-sectional studies (AXIS) was used to assess the quality of studies. Results: Twenty-three studies (17 papers and 6 conference abstracts), including 4674 participants (2481 with ulcerative colitis, 53.5% females) were included. Overall, 18 studies assessed CRC risk knowledge, 7 reported attitudes toward cancer screening, and 8 explored knowledge or attitude regarding colectomy for dysplasia. Patients demonstrated moderate awareness of CRC risk, limited knowledge of risk factors, and moderate levels of fear regarding this complication. Awareness of the diagnostic role of colonoscopy was high, but attitudes toward the procedure were mixed, largely due to concerns about complications. Awareness of appropriate screening initiation and willingness to undergo colectomy for dysplasia, regardless of the risk level, were generally low. Conclusions: Evidence on IBD patients' awareness of CRC risk and its management remains limited, restricting firm conclusion about the extent of knowledge and educational needs. Further research is required to better characterize patients' understanding and to inform targeted education strategies.