P0305 The Choice of Endoscopic Surveillance Strategies for IBD Patients Among Taiwanese Physicians: An Anonymous Questionnaire Survey
Authors: Chen Y Y , Huang C W , Yen H H 
Published: January 2025

Abstract

Background
Chronic inflammation caused by inflammatory bowel disease (IBD) increases the risk of patients developing colorectal cancer or dysplasia. Guidelines recommend that patients with IBD undergo regular colonoscopic surveillance based on factors such as the degree of inflammation, family history, and comorbidities. Previous studies have shown that chromoendoscopy has a higher detection rate for colorectal cancer screening, and most guidelines also recommend chromoendoscopy as the preferred endoscopic technique for colorectal cancer surveillance. Therefore, this questionnaire aims to understand the strategies used by physicians in Taiwan for colorectal neoplasia(CRN) screening in IBD patients.

Methods
The questionnaire will be distributed using an anonymous online survey at gastroenterology-related conferences and social media groups. It will include questions on the respondents’ hospital level, career duration, number of IBD patients under their care, and the ratio of biologics use. The survey will investigate their IBD surveillance strategies, such as the choice of endoscopic techniques, whether they use image-enhanced endoscopy (IEE), biopsy strategies, and non-invasive tools. The results will be analyzed to determine if there are differences in the selection of endoscopic techniques based on the variance in physician characteristics.

Results
A total of 53 physicians from Taiwan completed the survey. Of these, 39 (73.6%) were from tertiary-level hospitals, 37 (69.8%) had been practicing for over 10 years, 18 (34.0%) were caring for more than 50 IBD patients, and 11 (20.8%) had more than 30% of their IBD patients on biologics. Regarding the choice of endoscopic techniques, 25 (47.2%) used high-definition white light endoscopy (HD-WLE), 17 (32.1%) used standard-definition WLE, 11 (20.8%) used virtual chromoendoscopy, and none used chromoendoscopy. A total of 41 (77.4%) physicians used IEE (including virtual chromoendoscopy or WLE used in combination with IEE at inflammatory sites) for surveillance. The use of IEE was significantly associated with the number of IBD patients under care (p = 0.018), but there was no significant correlation with other physician characteristics. The reasons for selecting endoscopic techniques were as follows: 28 (52.8%) chose techniques for time efficiency, 20 (37.7%) based their choice on evidence-based medicine, and 5 (9.4%) were limited by the availability of endoscopic techniques. Besides, a total of 46 (86.8%) physicians adopted the target biopsy strategy.

Conclusion
The proportion of Taiwanese physicians using chromoendoscopy for IBD surveillance is relatively low. Additionally, physicians who care for a greater number of IBD patients are more likely to use IEE as a surveillance tool.

References
1.Yen HH, Weng MT, Tung CC, et al. Epidemiological trend in inflammatory bowel disease in taiwan from 2001 to 2015: A nationwide populationbased study. Intest Res 2019;17:54-62.
2.Ng SC, Bernstein CN, Vatn MH, et al. Geographical variability and environmental risk factors in inflammatory bowel disease. Gut 2013;62:630-49.
3.Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: A systematic review of population-based studies. Lancet 2017;390:2769-78.
4.Kaplan GG. The global burden of ibd: From 2015 to 2025. Nat Rev Gastroenterol Hepatol 2015;12:720-7.