Endoscopic Management Of Individuals At High-Risk Of Gastrointestinal Cancer: A Multicentre Survey In Spain

Aims Population at increased lifetime risk of gastrointestinal cancer, due to hereditary factors as Lynch syndrome (LS), familial adenomatous polyposis (FAP), hereditary diffuse gastric cancer (HDGC), or due to self-conditions as serrated polyposis syndrome (SPS) or inflammatory bowel disease (IBD), need specific endoscopic surveillance. Recently several European and American Endoscopy Societies have published guidelines concerning the endoscopic management of these high-risk cancer syndromes. The aim of our study was to determine how these patients are handled in our endoscopy units and if guidelines recommendations are followed.

Methods An on-line questionnaire was sent to all members of the EndoCAR group, a research group of the Spanish Society of Digestive Endoscopy focused on endoscopic management of patients at high-risk of gastrointestinal cancer. All responses were collected during November 2020.

Results Forty-eight endoscopists from 28 Spanish centres filled the online questionnaire. Most of them (91.5 %) are involved in a high-risk gastrointestinal cancer unit. Specific endoscopy timetables are scheduled for these patients in 62.5 % of procedures. High-definition endoscopy systems are always used for 87.5 % of endoscopists, occasionally for 7.5 % and never for 5 % of them. The use of virtual chromoendoscopy (VCE), dye-based chromoendoscopy (CE) or high definition white-light endoscopy (HD-WLE) in each high-risk group of patients (LS, FAP, SPS, IBD or HDGC) during surveillance is indicated on the table.

Tab. 1 Use of imaging techniques in individuals at high-risk of gastrointestinal cancer.

	HD-VCE	HD-CE	HD-WLE	No HD No CE
LS	40 %	25 %	20 %	15 %
SPS	30 %	42,5 %	15 %	12.5 %
IBD	25 %	65 %	2.5 %	5 %
FAP	27.5 %	32.5 %	30 %	10 %

LS: Lynch Syndrome. SPS: Serrated Polyposis Syndrome. IBD: Inflammatory Bowel Disease. FAP: Familial Adenomatous Polyposis. HD: High Definition. VCE: virtual chromoendoscopy. CE: dye-based Chromoendoscopy. WLE: White Light Endoscopy.

Conclusions Most endoscopists surveyed use high definition endoscopes during high-risk gastrointestinal cancer patient surveillance, following recent guidelines recommendations. The use of HD-WLE, VCE and CE varies depending on the patient´s syndrome or risk condition, and does not always follow guidelines recommendations.

Citation: López-Vicente J, Rodriguez Alcalde D, Hernández Villalba L et al. OP201 ENDOSCOPIC MANAGEMENT OF INDIVIDUALS AT HIGH-RISK OF GASTROINTESTINAL CANCER: A MULTICENTRE SURVEY IN SPAIN. Endoscopy 2021; 53: S83.

Publication History

Article published online:
19 March 2021