Update from 2010 (standard operating procedure): protocol for the 2024 British Society of Gastroenterology Guidelines on colorectal surveillance in inflammatory bowel disease

Morris Gordon¹, Gaurav Bhaskar Nigam², Vassiliki Sinopoulou³, Ibrahim Al Bakir⁴, Adrian C Bateman⁵, Shahida Din^{6

7}, Sunil Dolwani⁸, Anjan Dhar^{9

10}, O D Faiz^{11

12}, Bu Hayee¹³, Chris Healey¹⁴, Christopher Andrew Lamb¹⁵, Simon Leedham², Misha Kabir¹⁶, Marietta Iacucci^{17

18}, Ailsa Hart¹⁹, A John Morris²⁰, Marco Novelli²¹, Tim Raine²², Matt Rutter²³, Neil A Shepherd²⁴, Venkataraman Subramanian²⁵, Nigel J Trudgill²⁶, Maggie Vance¹², Ana Wilson^{12

27}, Lydia White²⁸, Ruth Wakeman²⁹, James E East²⁸

Affiliations

¹ BEST unit, University of Central Lancashire, Preston, UK MGordon@uclan.ac.uk.
² University of Oxford Translational Gastroenterology Unit, Oxford, UK.
³ University of Central Lancashire, Preston, Lancashire, UK.
⁴ Gastroenterology Department, Chelsea and Westminster Hospital, London, UK.
⁵ Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
⁶ Gastroenterology, NHS Lothian, Edinburgh, UK.
⁷ NHS Research Scotland, Clydebank, West Dunbartonshire, UK.
⁸ Gastroenterology, Cardiff and Vale NHS Trust, Cardiff, UK.
⁹ Gastroenterology, County Durham and Darlington NHS Foundation Trust, Darlington, UK.
¹⁰ School of Health and Life Sciences, Teesside University, Middlesbrough, UK.
¹¹ Department of Surgery and Cancer or Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
¹² St Mark's Hospital and Academic Institute, London, London, UK.
¹³ King's College Hospital NHS Foundation Trust, London, UK.
¹⁴ Gastroenterology, Airedale NHS Foundation Trust, Keighley, UK.
¹⁵ Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
¹⁶ University College London, London, UK.
¹⁷ University College Cork, Cork, Cork, Ireland.
¹⁸ University of Birmingham, Birmingham, UK.
¹⁹ St Mark's Hospital, London, UK.
²⁰ Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK.
²¹ Department of Histopathology, University College London, London, UK.
²² Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
²³ University Hospital of North Tees, Stockton-on-Tees, UK.
²⁴ Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, Gloucestershire, UK.
²⁵ Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
²⁶ Department of Gastroenterology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
²⁷ Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
²⁸ Nuffield Department of Medicine, University of Oxford Translational Gastroenterology Unit, Oxford, UK.
²⁹ Crohn's & Colitis UK, Hatfield, Hertfordshire, UK.

PMID: 39615897
PMCID: PMC11624704
DOI: 10.1136/bmjgast-2024-001541

Practice Guideline

Update from 2010 (standard operating procedure): protocol for the 2024 British Society of Gastroenterology Guidelines on colorectal surveillance in inflammatory bowel disease

Morris Gordon et al. BMJ Open Gastroenterol. 2024.

. 2024 Nov 29;11(1):e001541.

doi: 10.1136/bmjgast-2024-001541.

Authors

Affiliations

¹ BEST unit, University of Central Lancashire, Preston, UK MGordon@uclan.ac.uk.
² University of Oxford Translational Gastroenterology Unit, Oxford, UK.
³ University of Central Lancashire, Preston, Lancashire, UK.
⁴ Gastroenterology Department, Chelsea and Westminster Hospital, London, UK.
⁵ Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
⁶ Gastroenterology, NHS Lothian, Edinburgh, UK.
⁷ NHS Research Scotland, Clydebank, West Dunbartonshire, UK.
⁸ Gastroenterology, Cardiff and Vale NHS Trust, Cardiff, UK.
⁹ Gastroenterology, County Durham and Darlington NHS Foundation Trust, Darlington, UK.
¹⁰ School of Health and Life Sciences, Teesside University, Middlesbrough, UK.
¹¹ Department of Surgery and Cancer or Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
¹² St Mark's Hospital and Academic Institute, London, London, UK.
¹³ King's College Hospital NHS Foundation Trust, London, UK.
¹⁴ Gastroenterology, Airedale NHS Foundation Trust, Keighley, UK.
¹⁵ Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
¹⁶ University College London, London, UK.
¹⁷ University College Cork, Cork, Cork, Ireland.
¹⁸ University of Birmingham, Birmingham, UK.
¹⁹ St Mark's Hospital, London, UK.
²⁰ Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK.
²¹ Department of Histopathology, University College London, London, UK.
²² Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
²³ University Hospital of North Tees, Stockton-on-Tees, UK.
²⁴ Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, Gloucestershire, UK.
²⁵ Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
²⁶ Department of Gastroenterology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
²⁷ Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
²⁸ Nuffield Department of Medicine, University of Oxford Translational Gastroenterology Unit, Oxford, UK.
²⁹ Crohn's & Colitis UK, Hatfield, Hertfordshire, UK.

PMID: 39615897
PMCID: PMC11624704
DOI: 10.1136/bmjgast-2024-001541

Abstract

Introduction: The evolving landscape of inflammatory bowel disease (IBD) necessitates refining colonoscopic surveillance guidelines. This study outlines methodology adopted by the British Society of Gastroenterology (BSG) Guideline Development Group (GDG) for updating IBD colorectal surveillance guidelines.

Methods and analysis: The 'Grading of Recommendations, Assessment, Development and Evaluation' (GRADE) approach, as outlined in the GRADE handbook, was employed. Thematic questions were formulated using either the 'patient, intervention, comparison and outcome' format or the 'current state of knowledge, area of interest, potential impact and suggestions from experts in the field' format. The evidence review process included systematic reviews assessed using appropriate appraisal tools. An extensive list of potential outcomes was compiled from literature and expert consultations and then ranked by GDG members. The top outcomes were identified for evidence synthesis in three key areas: utility of surveillance in IBD, quality of bowel preparation and use of advanced imaging techniques in colonoscopy for IBD. Risk thresholding exercises determined specific risk levels for different surveillance strategies and intervals. This approach enabled the GDG to establish precise thresholds for interventions based on relative and absolute risk assessments, directly informing the stratification of surveillance recommendations. Significance of effect sizes (small, moderate, large) will guide the final GRADE assessment of the evidence.

Ethics and dissemination: Ethics approval is not applicable. By integrating clinical expertise, patient experiences and innovative methodologies like risk thresholding, we aim to deliver actionable recommendations for IBD colorectal surveillance. This protocol, complementing the main guidelines, offers GDGs, clinical trialists and practitioners a framework to inform future research and enhance patient care and outcomes.

Keywords: COLORECTAL CANCER; DYSPLASIA; INFLAMMATORY BOWEL DISEASE; SURVEILLANCE.

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Conflict of interest statement

Competing interests: MG is an editor for Cochrane, supporting clinical truth and unbiased synthesis since 2017 (ongoing). GBN, VS, IAB, AB, SDO, OF, BH, JM, MN, NS, VSU and JEE have no competing interests to declare related to the manuscript. SD is a committee member of the BSG IBD Section (2019–2025) and National Lead for IBD Colorectal Cancer Surveillance for the Scottish Government's National Centre for Sustainable Delivery (2020–2025). AD has received speaker fees and honoraria from AbbVie (2023–present), with his department receiving advisory fees, speaker fees and consultancy support from Tillotts UK (since 2022) and speaker fees, honoraria and advisory support from Takeda (since 2022). CH is employed as a JAG assessor, with JAG using standards to guide the assessment of endoscopy units for accreditation. CL has received research support and/or fees for non-promotional education from Janssen, Takeda, AbbVie, AstraZeneca, Eli Lilly, Orion, Pfizer, Roche, Sanofi Aventis, Ferring, UCB, Nordic Pharma, Dr Falk and Biogen (2019–present), as well as research support from Genentech Inc. (2012–present); he is also the Secretary of the IBD Section for the British Society of Gastroenterology (2021–present). AH has received lecture and advisory board fees from Janssen, Takeda, Celltrion, Galapagos, AbbVie and Lilly (2017–present), and her department has received sponsorships for meetings from Janssen, Takeda, Celltrion, Galapagos and AbbVie (2020–present); she is also a Governing Board member of ECCO (since 2018) and a Scientific Board member of Crohn's and Colitis UK (since 2011). TR has undertaken paid consultancy work for Abbvie, Arena, Aslan, AstraZeneca, Boehringer-Ingelheim, BMS, Eli Lilly, Ferring, Galapagos, Gilead, GSK, Heptares, LabGenius, Janssen, Pfizer, Roche, Takeda, UCB and XAP Therapeutics (since 2020), and he is a director of Endoread Ltd. (since 2022); he serves on the Scientific Committee of ECCO (since 2022) and United European Gastroenterology (since 2021). MR is a Regional Endoscopy Advisor for NHS England (since 2021) and Chair of JAG (since 2023). NT serves on the advisory board for Dr Falk UK concerning EoE and Jorveza (current), and his department receives research support, speaker fees and conference support from Dr Falk UK (research support is current). LW has served on advisory boards for Pfizer (May 2023), BMS (June 2023), Celltrion (June 2023) and Dr Falk (June 2023); she has received a speaker’s honorarium from Takeda (February 2023) and conference attendance support from Dr Falk (June 2023); she also receives editorial royalties for the Inflammatory Bowel Disease Nursing Manual (2019). RW is an employee of Crohn’s & Colitis UK (since October 2019) and Crohn’s & Colitis UK receives funding from various sources, as detailed in their annual accounts (published online).

References

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Update from 2010 (standard operating procedure): protocol for the 2024 British Society of Gastroenterology Guidelines on colorectal surveillance in inflammatory bowel disease

Affiliations

Update from 2010 (standard operating procedure): protocol for the 2024 British Society of Gastroenterology Guidelines on colorectal surveillance in inflammatory bowel disease

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous