British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease
East, James Edward Gordon, Morris Nigam, Gaurav Bhaskar Sinopoulou, Vassiliki Bateman, Adrian C Din, Shahida Iacucci, Marietta Kabir, Misha Lamb, Christopher Andrew Wilson, Ana
East, James Edward
Gordon, Morris
Nigam, Gaurav Bhaskar
Sinopoulou, Vassiliki
Bateman, Adrian C
Din, Shahida
Iacucci, Marietta
Kabir, Misha
Lamb, Christopher Andrew
Wilson, Ana
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Affiliation
John Radcliffe Hospital; University of Central Lancashire; University Hospital Southampton NHS Foundation Trust; Sandwell and West Birmingham NHS Trust; et al.
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Publication date
2025-04-30
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Abstract
Patients with inflammatory bowel disease (IBD) remain at increased risk for colorectal cancer and death from colorectal cancer compared with the general population despite improvements in inflammation control with advanced therapies, colonoscopic surveillance and reductions in environmental risk factors. This guideline update from 2010 for colorectal surveillance of patients over 16 years with colonic inflammatory bowel disease was developed by stakeholders representing UK physicians, endoscopists, surgeons, specialist nurses and patients with GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodological support.An a priori protocol was published describing the approach to three levels of statement: GRADE recommendations, good practice statements or expert opinion statements. A systematic review of 7599 publications, with appraisal and GRADE analysis of trials and network meta-analysis, where appropriate, was performed. Risk thresholding guided GRADE judgements.We made 73 statements for the delivery of an IBD colorectal surveillance service, including outcome standards for service and endoscopist audit, and the importance of shared decision-making with patients.Core areas include: risk of colorectal cancer, IBD-related post-colonoscopy colorectal cancer; service organisation and supporting patient concordance; starting and stopping surveillance, who should or should not receive surveillance; risk stratification, including web-based multivariate risk calculation of surveillance intervals; colonoscopic modalities, bowel preparation, biomarkers and artificial intelligence aided detection; chemoprevention; the role of non-conventional dysplasia, serrated lesions and non-targeted biopsies; management of dysplasia, both endoscopic and surgical, and the structure and role of the multidisciplinary team in IBD dysplasia management; training in IBD colonoscopic surveillance, sustainability (green endoscopy), cost-effectiveness and patient experience. Sixteen research priorities are suggested.
Citation
East JE, Gordon M, Nigam GB, Sinopoulou V, Bateman AC, Din S, Iacucci M, Kabir M, Lamb CA, Wilson A, Al Bakir I, Dhar A, Dolwani S, Faiz O, Hart A, Hayee B, Healey C, Leedham SJ, Novelli MR, Raine T, Rutter MD, Shepherd NA, Subramanian V, Vance M, Wakeman R, White L, Trudgill NJ, Morris AJ. British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease. Gut. 2025 Apr 30:gutjnl-2025-335023. doi: 10.1136/gutjnl-2025-335023. Epub ahead of print
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Article