{
  "abstract": "Introduction The 2025 British Society of Gastroenterology (BSG) inflammatory bowel disease (IBD) surveillance guidelines introduced updated risk stratification for colorectal neoplasia, leading to revised recommendations for surveillance colonoscopy intervals. While higher-risk patients may require more frequent surveillance, lower-risk individuals may undergo less intensive follow-up, including transition to population-based screening. The advanced colorectal neoplasia risk (aCRN) calculator, recommended by the BSG, was also incorporated into the guidelines. We aimed to assess the impact of the 2025 guidelines on surveillance recommendations in a large UK tertiary centre.Methods Patients with IBD on the waiting list for surveillance colonoscopy before the release of 2025 guidelines were identified. Clinical and endoscopic data were abstracted from electronic health records and the risk reassessed based on the 2025 IBD surveillance guidelines. The aCRN calculator was applied, and differences between previous and updated surveillance recommendations were analysed.Results A total of 165 patients were initially identified, of whom 14 were excluded due to factors including refusal of colonoscopy, the presence of strictures, colorectal cancer, family history of colorectal cancer, or paediatric-onset disease.Of the remaining 151 patients, 116 (77%) had ulcerative colitis, 22 (14%) had Crohn’s disease with colonic involvement, and the remainder had IBD-unclassified. The median age was 56 years (range 26–80).Applying the 2025 guidelines, 84 patients (out of 151; 55%) were re-classified as very low risk and hence only ­requiring ­population-based screening – this represents a substantial reduction in surveillance colonoscopy burden. When the aCRN calculator was used to risk stratify, 108 patients (out of 151; 71.5%) were classified as very low risk and suitable for population-based screening alone.Conclusion Implementation of the 2025 IBD surveillance guidelines results in more than half of patients previously undergoing surveillance colonoscopy being managed with population-based screening. It is essential that patients are appropriately counselled regarding their lower colorectal cancer risk and reassured when transitioning to population-based screening. These findings support a more individualised, risk-based approach to colorectal cancer surveillance in IBD, recognising that although IBD confers an increased cancer risk overall, this risk is substantially lower in many patients than previously assumed. Caution is warranted when applying the aCRN calculator, as discrepancies in surveillance interval recommendations were observed.",
  "authors": [
    {
      "affiliations": [
        "Nottingham University Hospital NHS Trust, Nottingham, United Kingdom"
      ],
      "name": "Ahmad Kadri"
    },
    {
      "affiliations": [
        "Nottingham University Hospital NHS Trust, Nottingham, United Kingdom"
      ],
      "name": "Siddhee Pradhan"
    },
    {
      "affiliations": [
        "Nottingham University Hospital NHS Trust, Nottingham, United Kingdom"
      ],
      "name": "Krishna Shreya"
    },
    {
      "affiliations": [
        "Nottingham University Hospital NHS Trust, Nottingham, United Kingdom"
      ],
      "name": "Samuel Sunil"
    }
  ],
  "title": "P247 Changes in IBD surveillance practice following implementation of the 2025 guidelines",
  "uid": "d97bf1f1-878c-5724-a125-0e9aef0ba491"
}