Surveillance for dysplasia in patients with ulcerative colitis: Discrepancy between guidelines and practice

Masaru Shinozaki, Kiyonori Kobayashi, Reiko Kunisaki, Tadakazu Hisamatsu, Makoto Naganuma, Ken Ichi Takahashi, Yasushi Iwao, Yasuo Suzuki, Mamoru Watanabe, Michio Itabashi, Akira Torii, Masakazu Takazoe, Akira Sugita

Research output: Contribution to journalArticle

Abstract

Background and Aim : The risk of developing colorectal cancer is higher in patients with ulcerative colitis (UC) than in the general population. Guidelines recommend surveillance colonoscopy (SCS) to reduce mortality ; however, few studies have assessed physicians' adherence to guidelines. This study was aimed to clarify the current status of SCS and adherence to guidelines through the characteristics of cancer/dysplasia surveillance for UC patients in Japan. Methods : A questionnaire was mailed to 541 physicians who attended meetings on inflammatory bowel disease. Results : The respondents encountered a median of 100 UC cases. Thirty percent of the respondents had never managed a UC patient with cancer. Fifty-one percent of the respondents had never diagnosed colorectal cancer with UC. Forty-seven percent of the respondents considered extensive colitis and left-sided colitis as indications for SCS, and 38% carried out SCS regardless of the disease extent. Sixty-three percent of the respondents started SCS at 7-10 years after UC onset, whereas 20% started SCS at 3 years or less. Fifty-two percent of the respondents obtained targeted biopsies only, and chromoendoscopy was used by 49% of the respondents as a special technique for surveillance. Median number of biopsies at SCS was five per patient ; it was three among patients whose biopsy was carried out by physicians who obtained targeted biopsies only and seven among those carried out by physicians who obtained step biopsies and targeted biopsies (P < 0.0001). Conclusion : A considerable proportion of the respondents did not follow the guidelines when selecting patients for surveillance and carrying out SCS.

Original languageEnglish
Pages (from-to)1033-1043
Number of pages11
JournalGastroenterological Endoscopy
Volume60
Issue number4
DOIs
Publication statusPublished - 2018 Apr 1

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Ulcerative Colitis
Practice Guidelines
Colonoscopy
Biopsy
Physicians
Guideline Adherence
Colitis
Colorectal Neoplasms
Guidelines
Surveys and Questionnaires
Inflammatory Bowel Diseases
Neoplasms
Japan
Mortality
Population

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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Surveillance for dysplasia in patients with ulcerative colitis : Discrepancy between guidelines and practice. / Shinozaki, Masaru; Kobayashi, Kiyonori; Kunisaki, Reiko; Hisamatsu, Tadakazu; Naganuma, Makoto; Takahashi, Ken Ichi; Iwao, Yasushi; Suzuki, Yasuo; Watanabe, Mamoru; Itabashi, Michio; Torii, Akira; Takazoe, Masakazu; Sugita, Akira.

In: Gastroenterological Endoscopy, Vol. 60, No. 4, 01.04.2018, p. 1033-1043.

Research output: Contribution to journalArticle

Shinozaki, M, Kobayashi, K, Kunisaki, R, Hisamatsu, T, Naganuma, M, Takahashi, KI, Iwao, Y, Suzuki, Y, Watanabe, M, Itabashi, M, Torii, A, Takazoe, M & Sugita, A 2018, 'Surveillance for dysplasia in patients with ulcerative colitis: Discrepancy between guidelines and practice', Gastroenterological Endoscopy, vol. 60, no. 4, pp. 1033-1043. https://doi.org/10.11280/gee.60.1033
Shinozaki, Masaru ; Kobayashi, Kiyonori ; Kunisaki, Reiko ; Hisamatsu, Tadakazu ; Naganuma, Makoto ; Takahashi, Ken Ichi ; Iwao, Yasushi ; Suzuki, Yasuo ; Watanabe, Mamoru ; Itabashi, Michio ; Torii, Akira ; Takazoe, Masakazu ; Sugita, Akira. / Surveillance for dysplasia in patients with ulcerative colitis : Discrepancy between guidelines and practice. In: Gastroenterological Endoscopy. 2018 ; Vol. 60, No. 4. pp. 1033-1043.
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AU - Hisamatsu, Tadakazu

AU - Naganuma, Makoto

AU - Takahashi, Ken Ichi

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AU - Suzuki, Yasuo

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AU - Itabashi, Michio

AU - Torii, Akira

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