P054 IBD Associated Surveillance Dysplasia Program: New Integrated Model: Audit, Summary, Future Directions and...

Area of Science:

• Gastroenterology
• Oncology
• Clinical Management

Background:

• Current guidelines recommend colorectal cancer (CRC) screening for inflammatory bowel disease (IBD) patients after 8 years of disease duration, with specific criteria for ulcerative colitis (UC) and Crohn's disease (CD).
• Exceptions include patients with primary sclerosing cholangitis (PSC) or a family history of CRC, requiring earlier or annual surveillance.
• Surveillance of ileoanal pouches post-restorative proctectomy is not universally defined but generally not recommended without high-risk features.

Purpose of the Study:

• To enhance the surveillance pathway for patients with IBD.
• To optimize resource allocation for surveillance procedures.
• To identify suitable patients for research and clinical trials.

Main Methods:

• A multidisciplinary team (MDT) reviewed cases referred from a prospective booking database.
• Cases were assessed for appropriateness based on established IBD surveillance guidelines.
• Data management included collating patient information, assessing bowel preparation, recording outcomes, and allocating patients to appropriate endoscopy lists.

Main Results:

• Over 12 monthly meetings, 356 cases were screened, with 62 meeting inclusion criteria, predominantly UC and Crohn's disease patients.
• A majority of reviewed cases (43/62) were categorized as high-risk for colorectal cancer.
• The MDT identified 10 new PSC cases early, improved bowel preparation protocols, and highlighted areas for improvement in referral pathways and patient attendance.

Conclusions:

• The IBD surveillance MDT is an effective tool for improving the quality of care and reallocating procedures.
• This model facilitates appropriate monitoring for all IBD dysplasia surveillance cases, including those with complex risk factors or those outside standard guidelines.
• Resource allocation is necessary to fully implement this clinically useful model.