British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease

James Edward East; Morris Gordon; Gaurav Bhaskar Nigam; Vassiliki Sinopoulou; Adrian C Bateman; Shahida Din; Marietta Iacucci; Misha Kabir; Christopher Andrew Lamb; Ana Wilson; Ibrahim Al Bakir; Anjan Dhar; Sunil Dolwani; Omar Faiz; Ailsa Hart; Bu’Hussain Hayee; Chris Healey; Simon John Leedham; Marco R Novelli; Tim Raine; Matthew D Rutter; Neil A Shepherd; Venkataraman Subramanian; Margaret Vance; Ruth Wakeman; Lydia White; Nigel J Trudgill; A John Morris

doi:10.1136/gutjnl-2025-335023

British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease

James Edward East, Morris Gordon, Gaurav Bhaskar Nigam, Vassiliki Sinopoulou, Adrian C Bateman, Shahida Din, Marietta Iacucci, Misha Kabir, Christopher Andrew Lamb, Ana Wilson, Ibrahim Al Bakir, Anjan Dhar, Sunil Dolwani, Omar Faiz, Ailsa Hart, Bu’Hussain Hayee, Chris Healey, Simon John Leedham, Marco R Novelli, Tim RaineMatthew D Rutter, Neil A Shepherd, Venkataraman Subramanian, Margaret Vance, Ruth Wakeman, Lydia White, Nigel J Trudgill, A John Morris

Research output: Contribution to journal › Article › peer-review

Abstract

Patients with inflammatory bowel disease (IBD) remain at increased risk for colorectal cancer and death from colorectal cancer compared with the general population
despite improvements in inflammation control with advanced therapies, colonoscopic surveillance and reductions in environmental risk factors. This guideline update from 2010 for colorectal surveillance of patients over 16 years with colonic inflammatory bowel disease was developed by stakeholders representing UK physicians, endoscopists, surgeons, specialist nurses and patients with GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodological support. An a priori protocol was published describing the approach to three levels of statement: GRADE recommendations, good practice statements or expert
opinion statements. A systematic review of 7599 publications, with appraisal and GRADE analysis of trials and network meta-analysis, where appropriate, was performed. Risk thresholding guided GRADE judgements. We made 73 statements for the delivery of an IBD colorectal surveillance service, including outcome
standards for service and endoscopist audit, and the importance of shared decision-making with patients. Core areas include: risk of colorectal cancer, IBD-related
post-colonoscopy colorectal cancer; service organisation and supporting patient concordance; starting and stopping surveillance, who should or should not receive surveillance; risk stratification, including web-based multivariate risk calculation of surveillance intervals; colonoscopic modalities, bowel preparation, biomarkers and artificial intelligence aided detection; chemoprevention; the role of non-conventional
dysplasia, serrated lesions and non-targeted biopsies; management of dysplasia, both endoscopic and surgical, and the structure and role of the multidisciplinary team in IBD dysplasia management; training in IBD colonoscopic surveillance, sustainability (green endoscopy), cost-effectiveness and patient experience. Sixteen research priorities are suggested.

Original language	English
Article number	335023
Pages (from-to)	gutjnl-2025-335023
Journal	Gut
Early online date	1 May 2025
DOIs	https://doi.org/10.1136/gutjnl-2025-335023
Publication status	E-pub ahead of print - 1 May 2025

Keywords / Materials (for Non-textual outputs)

COLONOSCOPY
COLORECTAL CANCER SCREENING
COLORECTAL NEOPLASIA
ENDOSCOPY
IBD

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British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease_final
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Cite this

East, J. E., Gordon, M., Nigam, G. B., Sinopoulou, V., Bateman, A. C., Din, S., Iacucci, M., Kabir, M., Lamb, C. A., Wilson, A., Al Bakir, I., Dhar, A., Dolwani, S., Faiz, O., Hart, A., Hayee, BH., Healey, C., Leedham, S. J., Novelli, M. R., ... Morris, A. J. (2025). British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease. Gut, gutjnl-2025-335023. Article 335023. Advance online publication. https://doi.org/10.1136/gutjnl-2025-335023

@article{7cd10bb038654cf79cc38f17f1865dcf,

title = "British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease",

abstract = "Patients with inflammatory bowel disease (IBD) remain at increased risk for colorectal cancer and death from colorectal cancer compared with the general population despite improvements in inflammation control with advanced therapies, colonoscopic surveillance and reductions in environmental risk factors. This guideline update from 2010 for colorectal surveillance of patients over 16 years with colonic inflammatory bowel disease was developed by stakeholders representing UK physicians, endoscopists, surgeons, specialist nurses and patients with GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodological support. An a priori protocol was published describing the approach to three levels of statement: GRADE recommendations, good practice statements or expert opinion statements. A systematic review of 7599 publications, with appraisal and GRADE analysis of trials and network meta-analysis, where appropriate, was performed. Risk thresholding guided GRADE judgements. We made 73 statements for the delivery of an IBD colorectal surveillance service, including outcome standards for service and endoscopist audit, and the importance of shared decision-making with patients. Core areas include: risk of colorectal cancer, IBD-related post-colonoscopy colorectal cancer; service organisation and supporting patient concordance; starting and stopping surveillance, who should or should not receive surveillance; risk stratification, including web-based multivariate risk calculation of surveillance intervals; colonoscopic modalities, bowel preparation, biomarkers and artificial intelligence aided detection; chemoprevention; the role of non-conventional dysplasia, serrated lesions and non-targeted biopsies; management of dysplasia, both endoscopic and surgical, and the structure and role of the multidisciplinary team in IBD dysplasia management; training in IBD colonoscopic surveillance, sustainability (green endoscopy), cost-effectiveness and patient experience. Sixteen research priorities are suggested.",

keywords = "COLONOSCOPY, COLORECTAL CANCER SCREENING, COLORECTAL NEOPLASIA, ENDOSCOPY, IBD",

author = "East, \{James Edward\} and Morris Gordon and Nigam, \{Gaurav Bhaskar\} and Vassiliki Sinopoulou and Bateman, \{Adrian C\} and Shahida Din and Marietta Iacucci and Misha Kabir and Lamb, \{Christopher Andrew\} and Ana Wilson and \{Al Bakir\}, Ibrahim and Anjan Dhar and Sunil Dolwani and Omar Faiz and Ailsa Hart and Bu{\textquoteright}Hussain Hayee and Chris Healey and Leedham, \{Simon John\} and Novelli, \{Marco R\} and Tim Raine and Rutter, \{Matthew D\} and Shepherd, \{Neil A\} and Venkataraman Subramanian and Margaret Vance and Ruth Wakeman and Lydia White and Trudgill, \{Nigel J\} and Morris, \{A John\}",

year = "2025",

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day = "1",

doi = "10.1136/gutjnl-2025-335023",

language = "English",

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East, JE, Gordon, M, Nigam, GB, Sinopoulou, V, Bateman, AC, Din, S, Iacucci, M, Kabir, M, Lamb, CA, Wilson, A, Al Bakir, I, Dhar, A, Dolwani, S, Faiz, O, Hart, A, Hayee, BH, Healey, C, Leedham, SJ, Novelli, MR, Raine, T, Rutter, MD, Shepherd, NA, Subramanian, V, Vance, M, Wakeman, R, White, L, Trudgill, NJ & Morris, AJ 2025, 'British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease', Gut, pp. gutjnl-2025-335023. https://doi.org/10.1136/gutjnl-2025-335023

TY - JOUR

T1 - British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease

AU - East, James Edward

AU - Gordon, Morris

AU - Nigam, Gaurav Bhaskar

AU - Sinopoulou, Vassiliki

AU - Bateman, Adrian C

AU - Din, Shahida

AU - Iacucci, Marietta

AU - Kabir, Misha

AU - Lamb, Christopher Andrew

AU - Wilson, Ana

AU - Al Bakir, Ibrahim

AU - Dhar, Anjan

AU - Dolwani, Sunil

AU - Faiz, Omar

AU - Hart, Ailsa

AU - Hayee, Bu’Hussain

AU - Healey, Chris

AU - Leedham, Simon John

AU - Novelli, Marco R

AU - Raine, Tim

AU - Rutter, Matthew D

AU - Shepherd, Neil A

AU - Subramanian, Venkataraman

AU - Vance, Margaret

AU - Wakeman, Ruth

AU - White, Lydia

AU - Trudgill, Nigel J

AU - Morris, A John

PY - 2025/5/1

Y1 - 2025/5/1

N2 - Patients with inflammatory bowel disease (IBD) remain at increased risk for colorectal cancer and death from colorectal cancer compared with the general population despite improvements in inflammation control with advanced therapies, colonoscopic surveillance and reductions in environmental risk factors. This guideline update from 2010 for colorectal surveillance of patients over 16 years with colonic inflammatory bowel disease was developed by stakeholders representing UK physicians, endoscopists, surgeons, specialist nurses and patients with GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodological support. An a priori protocol was published describing the approach to three levels of statement: GRADE recommendations, good practice statements or expert opinion statements. A systematic review of 7599 publications, with appraisal and GRADE analysis of trials and network meta-analysis, where appropriate, was performed. Risk thresholding guided GRADE judgements. We made 73 statements for the delivery of an IBD colorectal surveillance service, including outcome standards for service and endoscopist audit, and the importance of shared decision-making with patients. Core areas include: risk of colorectal cancer, IBD-related post-colonoscopy colorectal cancer; service organisation and supporting patient concordance; starting and stopping surveillance, who should or should not receive surveillance; risk stratification, including web-based multivariate risk calculation of surveillance intervals; colonoscopic modalities, bowel preparation, biomarkers and artificial intelligence aided detection; chemoprevention; the role of non-conventional dysplasia, serrated lesions and non-targeted biopsies; management of dysplasia, both endoscopic and surgical, and the structure and role of the multidisciplinary team in IBD dysplasia management; training in IBD colonoscopic surveillance, sustainability (green endoscopy), cost-effectiveness and patient experience. Sixteen research priorities are suggested.

AB - Patients with inflammatory bowel disease (IBD) remain at increased risk for colorectal cancer and death from colorectal cancer compared with the general population despite improvements in inflammation control with advanced therapies, colonoscopic surveillance and reductions in environmental risk factors. This guideline update from 2010 for colorectal surveillance of patients over 16 years with colonic inflammatory bowel disease was developed by stakeholders representing UK physicians, endoscopists, surgeons, specialist nurses and patients with GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodological support. An a priori protocol was published describing the approach to three levels of statement: GRADE recommendations, good practice statements or expert opinion statements. A systematic review of 7599 publications, with appraisal and GRADE analysis of trials and network meta-analysis, where appropriate, was performed. Risk thresholding guided GRADE judgements. We made 73 statements for the delivery of an IBD colorectal surveillance service, including outcome standards for service and endoscopist audit, and the importance of shared decision-making with patients. Core areas include: risk of colorectal cancer, IBD-related post-colonoscopy colorectal cancer; service organisation and supporting patient concordance; starting and stopping surveillance, who should or should not receive surveillance; risk stratification, including web-based multivariate risk calculation of surveillance intervals; colonoscopic modalities, bowel preparation, biomarkers and artificial intelligence aided detection; chemoprevention; the role of non-conventional dysplasia, serrated lesions and non-targeted biopsies; management of dysplasia, both endoscopic and surgical, and the structure and role of the multidisciplinary team in IBD dysplasia management; training in IBD colonoscopic surveillance, sustainability (green endoscopy), cost-effectiveness and patient experience. Sixteen research priorities are suggested.

KW - COLONOSCOPY

KW - COLORECTAL CANCER SCREENING

KW - COLORECTAL NEOPLASIA

KW - ENDOSCOPY

KW - IBD

U2 - 10.1136/gutjnl-2025-335023

DO - 10.1136/gutjnl-2025-335023

M3 - Article

SN - 0017-5749

SP - gutjnl-2025-335023

JO - Gut

JF - Gut

M1 - 335023

ER -

British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease

Abstract

Keywords / Materials (for Non-textual outputs)

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