title: Adherence to surveillance guidelines for dysplasia and colorectal carcinoma in ulcerative and Crohn's colitis patients in the Netherlands.
abstract: OBJECTIVE
  To study adherence to the widely accepted surveillance guidelines for patients with long-standing colitis in The Netherlands.
  
  
  METHODS
  A questionnaire was sent to all 244 gastroenterologists in The Netherlands.
  
  
  RESULTS
  The response rate was 63%. Of all gastroenterologists, 95% performed endoscopic surveillance in ulcerative colitis (UC) patients and 65% in patients with Crohn's colitis. The American Gastroenterological Association (AGA) guidelines were followed by 27%, while 27% and 46% followed their local hospital protocol or no specific protocol, respectively. The surveillance was correctly initiated in cases of pancolitis by 53%, and in cases of left-sided colitis by 44% of the gastroenterologists. Although guidelines recommend 4 biopsies every 10 cm, less than 30 biopsies per colonoscopy were taken by 73% of the responders. Only 31%, 68% and 58% of the gastroenterologists referred patients for colectomy when low-grade dysplasia, high-grade dysplasia (HGD) or Dysplasia Associated Lesion or Mass (DALM) was present, respectively.
  
  
  CONCLUSIONS
  Most Dutch gastroenterologists perform endoscopic surveillance without following international recommended guidelines. This practice potentially leads to a decreased sensitivity for dysplasia, rendering screening for colorectal cancer in this population highly ineffective.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam 1105AZ, The Netherlands.
authors.forename: Anne F
authors.initials: AF
authors.lastname: van Rijn
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.forename: Bas
authors.initials: B
authors.lastname: Oldenburg
mesh_terms: D001706:Biopsy; D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000209:etiology*; D003424:Crohn Disease / Q000150:complications* / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D005762:Gastroenterology / Q000592:standards; D006801:Humans; D009426:Netherlands; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D013997:Time Factors