Gender Biases and Diagnostic Delay in Inflammatory Bowel Disease: Multicenter Observational Study

Area of Science:

• Gastroenterology
• Health Services Research
• Gender Studies

Background:

• Female gender is increasingly recognized as a potential factor contributing to diagnostic delays in inflammatory bowel disease (IBD).
• Understanding the specific causes of these delays is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate and compare diagnostic delays in women versus men with IBD.
• To identify potential causes for observed differences in diagnostic timelines, focusing on misdiagnosis rates.

Main Methods:

• A multicenter cohort study involving 190 patients with a recent diagnosis of IBD (disease duration <7 months).
• Clinical presentation and diagnostic processes were reconstructed using semistructured patient interviews and electronic medical records.
• Cox regression analysis was employed to identify independent variables associated with diagnostic delay.

Main Results:

• Women faced significantly longer median diagnostic delays for both Crohn's disease (12.6 vs 4.5 months) and ulcerative colitis (6.1 vs 2.7 months) compared to men.
• Women exhibited higher rates of misdiagnosis across all healthcare settings, including emergency departments, primary care, gastroenterology, and hospital admissions.
• Clinical presentation of IBD was similar between sexes, indicating that differences in symptoms did not account for the delay.

Conclusions:

• A significant diagnostic delay exists for women with IBD compared to men, driven by prolonged evaluation and higher misdiagnosis rates.
• Gender-based inequities in healthcare contribute to delayed diagnosis and treatment for women with IBD.
• Addressing systemic biases within the healthcare system is essential to ensure equitable and timely diagnosis for all patients with IBD.