{
  "abstract": "Introduction Patients with inflammatory bowel disease (IBD) are at increased risk of colorectal cancer (CRC). The 2025 British Society of Gastroenterology guidelines on CRC surveillance in IBD provide recommendations on risk stratification, surveillance intervals and endoscopic modality. This audit aimed to assess current clinical practice in the UK against these standards.Methodology We conducted a multicentre, trainee led retrospective audit of adult patients with IBD undergoing CRC ­surveillance between January and June 2024 across 17 UK centres. Patients were identified using endoscopy and clinical databases. Data collected included demographics, IBD type and disease activity, surveillance frequency and colonoscopic modality. Pseudonymised data were pooled centrally and analysed using Stata.Results A total of 1489 patients who underwent CRC surveillance were included (51.1% male; median age 54 years; 9% with primary sclerosing cholangitis [PSC]). Ulcerative colitis (UC) was the most common diagnosis (66.8%), followed by Crohn’s disease (27.5%) and IBD unclassified (5.8%). Among patients with UC and IBD unclassified, only 68.2% (737/1080) were taking mesalazine. High-definition white light endoscopy was used in 50.2% of procedures, chromoendoscopy in 48.7% and virtual chromoendoscopy (NBI/iScan/FICE) in 1%.Bowel preparation was rated excellent in 24% and good in 44% of procedures. Most patients had quiescent disease at colonoscopy (66%). Excluding patients with PSC, 35.5% (n=529) were undergoing their first surveillance procedure, however 69% of these waited longer than the recommended 8 years for initial surveillance (distribution peaked at 10 years). When compared to National Institute for Health and Care Excellence guidelines, initial surveillance within 10 years was not carried out in 46.9%.Among patients with PSC, only 42% (n=48) underwent surveillance within 1 year. In addition, among patients with a family history of CRC already undergoing regular surveillance, only 37.5% had a surveillance interval of 3 years. Amongst higher risk patients only 20% (12/60) with previous strictures and 22.4% (13/58) with prior dysplasia underwent surveillance within 1 year. Surveillance at 3 years occurred in 48% of those with previous post-inflammatory polyps.Conclusion Despite clear national guidance, adherence to recommended CRC surveillance intervals in IBD remains suboptimal. Variation persists in the use of recommended endoscopic techniques and chemoprevention. These findings highlight the need for improved systems to support risk stratification and timely surveillance in IBD care across the UK. These findings likely reflect significant pressures on UK endoscopy services. The new 2025 BSG guidelines may help rationalise surveillance demand and enable services to prioritise patients at highest risk.",
  "authors": [
    {
      "affiliations": [
        "Yorkshire and Humber Gastroenterology Audit and Research Trainee Network, United Kingdom"
      ],
      "name": "Yorkshire and Humber Gastroenterology Audit and Research Trainee Network"
    },
    {
      "affiliations": [
        "Yorkshire Cancer Research Bowel Cancer Improvement Programme, United Kingdom"
      ],
      "name": "Yorkshire Cancer Research Bowel Cancer Improvement Programme"
    },
    {
      "affiliations": [
        "Leeds Institute of Medical Research at St James’s, University of Leeds, United Kingdom",
        "Leeds Institute for Data Analytics, University of Leeds, United Kingdom"
      ],
      "name": "John Taylor"
    },
    {
      "affiliations": [
        "Mid Yorkshire Teaching NHS Trust, United Kingdom"
      ],
      "name": "Nicholas Burr"
    },
    {
      "affiliations": [
        "York and Scarborough Teaching Hospitals NHS Foundation Trust, United Kingdom"
      ],
      "name": "James Turvill"
    }
  ],
  "title": "P238 Colorectal cancer surveillance in patients with IBD - are we getting it right? A pan-UK trainee led audit (ColCaS IBD)",
  "uid": "539b99b9-19f8-5f81-94b8-57d891e5bc18"
}