Sex Disparities in Treatment Trajectories of Inflammatory Bowel Disease Are Associated With Diagnostic Delay.

Abstract

Background: Diagnostic delay (DD) is a common finding in inflammatory bowel diseases (IBD). The reasons and effects of this delay are frequently underestimated, particularly in the context of sex. Our aims were to examine the impact of delayed diagnosis in IBD, with a particular focus on sex disparities.

Methods: We performed a single-center, cross-sectional study at a tertiary referral center, including patients with IBD. The data was collected between August 2020 and June 2024.

Results: A total of 247 individuals with IBD were included in this study, with 53% identifying as female and 51% having Crohn's disease. Probability estimators revealed an effect of a DD on the cumulative advanced drug therapy probability in women (p_Log-Rank = 0.045). Further analysis of the interaction between therapeutic regimens and DD revealed significant differences between the sexes. Women with a longer latency in their diagnosis were more frequently treated with steroids only compared to men. Entity-specific DD was further identified as a risk factor for steroid-only treatment in women with IBD (OR: 2.6; 95% CI, 1.11-5.98; P = .028). Additionally, a notable disparity in quality of life was observed between women who exhibited DD and men, with the former demonstrating a significantly reduced quality of life.

Conclusions: A delayed diagnosis has a significant impact on IBD treatment trajectories, with a notable sex-related effect observed especially in women. Therapeutic needs in female patients with IBD seem underestimated, particularly in instances where a DD is present.