BACKGROUND AND AIMS: Previous studies reported significant variation in the management of @entity1 with @entity355 . However, these are based on self-reported clinical practice. The aim of this study was to examine the management of high-grade @entity1141 in @entity355 in England by using @entity1 -level data and to compare practice with guidelines. METHODS: From April 2012 to March 2013, National Health Service (NHS) trusts in England prospectively collected data on @entity1 newly diagnosed with high-grade @entity1141 (HGD) of the esophagus as part of the National Oesophago-Gastric Cancer Audit. Data were collected on @entity1 characteristics, diagnosis and endoscopic findings, treatment planning, and therapy. RESULTS: Between April 2012 and March 2013, NHS trusts reported 465 cases of HGD. Diagnosis was confirmed by a second pathologist in 79.4% of cases (270/340), and 86.0% (374/465) had their treatment planned at a multidisciplinary team meeting. A total of 290 @entity1 (62.4%) were managed endoscopically (frequently with endoscopic resection or radiofrequency ablation), whereas 26 @entity1 (5.6%) had esophagectomy. The proportion of @entity1 managed by surveillance varied by age (P  < .001), ranging from 19.5% in @entity1 aged  <65 years to 63.8% in @entity1 aged  >= 85 years. More @entity1 received active treatment if their cases were discussed at a multidisciplinary meeting (73.5% vs 44.3%; P  < .001) or managed at higher-volume trusts (87.8% vs 55.4%; P  < .001). CONCLUSIONS: There was marked variation in the management of HGD across England, with a third of @entity1 receiving no active treatment. @entity1 discussed at a specialist multidisciplinary meeting or managed in high-volume trusts were more likely to receive active treatment.

Management of Barrett's high-grade XXXX : initial results from a population-based national audit.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity1141 :: ('MESH:C535662', 'Disease') :: ['dysplasia'] @entity355 :: ('MESH:D001471', 'Disease') :: ["Barrett's esophagus"]
@entity1141 :: (MESH:C535662,Disease) :: ['dysplasia']
