Practice pattern variability among gastroenterologists in colorectal cancer surveillance and management of colorectal dysplasia in inflammatory bowel disease. Issue 8 (20th July 2021)

• Record Type: Journal Article
• Authors: Chan, Webber Pak Wo; Tan, Yu Bin; Shim, Hang Hock; Kaltenbach, Tonya; Soetikno, Roy
• Is Part Of: Journal of digestive diseases. Volume 22:Issue 8(2021)
• Page Start: 463
• Page End: 472
• Publication Date: 2021-07-20
• Subjects: chromoendoscopy -- colorectal neoplasms -- dysplasia -- inflammatory bowel diseases; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; 616.3
• DOI: 10.1111/1751-2980.13031
• Languages: English
• ISSNs: 1751-2972

Abstract

Abstract : Objective: There is debate on the best method of colorectal cancer (CRC) surveillance in inflammatory bowel disease (IBD). We aimed to examine how gastroenterologists around the world practice CRC surveillance and manage dysplastic lesions in IBD. Methods: A 22‐question survey was emailed to gastroenterologists from 34 countries. It included questions on resources for, frequency and mode of CRC surveillance, and management of colorectal dysplasia. Fisherʼs exact test and logistic regression were used to evaluate the differences among respondents in various domains. Results: There were 217 eligible responses, with most gastroenterologists working in public hospitals (76%), and treating >10 patients with IBD weekly (71%). High‐definition white light endoscopy (HDWLE) was available in 93.1% of the centers. The preferred mode of surveillance was HDWLE with dye‐spray chromoendoscopy and targeted biopsies (41.2%). Fewer than 50% of physicians reported using chromoendoscopy in >50% of cases, citing time as the limiting factor (73.7%). Of these gastroenterologists 63% infrequently (<25% of cases) performed random biopsies during chromoendoscopy. They would attempt endoscopic mucosal resection for polypoid lesions >10 mm (67.2%), including >20 mm lesions with low grade dysplasia (49.8%), and non‐polypoid lesions >10 mm without dysplasia (56.9%). For non‐polypoid lesions >20 mm with low‐ and high‐grade dysplasia, referral to expert endoscopists was the preferred option. Conclusion: The preferred method of CRC surveillance was HDWLE with chromoendoscopy and targeted biopsies. Random biopsies were infrequently performed. The uptake of chromoendoscopy for surveillance in practice was low. Physicians varied in their approach in removing endoscopically resectable dysplastic lesions. Abstract : The preferred method of colorectal cancer surveillance was high‐definition white light endoscopy with chromoendoscopy and targeted biopsies. Random biopsies were infrequently performed. The uptake of chromoendoscopy for surveillance in practice was low, with time as the limiting factor