Physicians' perceptions of dysplasia and approaches to surveillance colonoscopy in ulcerative colitis

摘要: OBJECTIVE Colonoscopic biopsy surveillance to detect dysplasia, defined as a neoplastic change of the epithelium without invasion into lamina propria, in patients with ulcerative colitis has become widespread practice. We undertook survey study determine physicians' perceptions of, and approaches to, dysplasia colonoscopy colitis. METHODS Members two regional gastroenterology associations United States, including both academic private practice-based gastroenterologists, group senior trainees were surveyed by means written questionnaire. The questionnaires distributed at three separate meetings practicing gastroenterologists or trainees: 1) Gastrointestinal pathology course for second-year fellows from training programs around States (February 1993, Los Angeles, CA); 2) meeting Southern California Gastroenterology Society (March 3) Pacific Northwest (June Seattle, Washington). percentages all responses tallied analyzed whole well subgroup analysis. Understanding definition specific practice techniques main outcomes sought. RESULTS Only 19% respondents correctly identified dysplasia. More (48%) high grade specifically compared only 16% who low majority (69%) recommended colectomy when was diagnosed, yet nearly one-third pursued continued this setting. Almost uniformly, not diagnosed. Nearly one-half thought that there < 20% chance finding invasive cancer preoperative diagnoses On average, performed every 1-2 yr took an average biopsies per site, approximately eight sites colon, most confidently relied on their local pathologist making diagnosis. There were, however, wide variations surveillance. CONCLUSIONS did know viewed it preneoplastic lesion. Furthermore, lack appreciation difference between is one degree severity likelihood surgery if diagnosis preoperatively. Dysplasia standardized, clearly understood screening tool, education community regarding its pitfalls needed.