Current United Kingdom practice in the diagnosis and management of columnar-lined oesophagus: results of the United Kingdom National Barrett's Oesophagus Registry endoscopist questionnaire.
The management of the columnar-lined oesophagus (CLO) has remained controversial for the last 10 years, with practices varying between individual physicians and centres throughout the United Kingdom. Various guidelines exist, although international consensus over issues such as the recognition of short-segment disease and surveillance policies for uncomplicated and dysplastic disease is lacking. Questionnaires examining the practice of diagnosis and surveillance of CLO were sent to 41 centres spread throughout the United Kingdom. Thirty (73%) centres replied. Twelve (40%) had a specific written policy for the management of CLO. Twenty-five (83%) centres made a diagnosis of CLO in the presence of any length of columnarization. Twenty-seven (90%) centres surveyed CLO with 81% of them undertaking a selective surveillance policy. Endoscopic surveillance intervals were fairly consistent for uncomplicated CLO and high-grade dysplasia, but were less consistent for low-grade dysplasia. Results confirmed that even amongst centres with a specialist interest in the management of CLO, marked variations exist in diagnosis and surveillance practice.
Ramus
James R
JR
UKBOR, University Department of Surgery, Royal Free Hospital, London, UK. jimramusuk@yahoo.co.uk
Caygill
Christine P J
CP
Gatenby
Piers A C
PA
Watson
Anthony
A
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D001706:Biopsy; D004935:Esophageal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D004945:Esophagoscopy / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D009367:Neoplasm Staging; D011159:Population Surveillance; D010818:Practice Patterns, Physicians'; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D012042:Registries; D011795:Surveys and Questionnaires; D006113:United Kingdom