You are here

  • Home
  • Archive
  • Volume 15, Issue 1
  • Dedicated service for Barrett’s oesophagus surveillance endoscopy yields higher dysplasia detection and guideline adherence in a non-tertiary setting in the UK: a 5-year comparative cohort study

Article Text

Article menu
Download PDFPDF
Oesophagus and stomach
Original research
Dedicated service for Barrett’s oesophagus surveillance endoscopy yields higher dysplasia detection and guideline adherence in a non-tertiary setting in the UK: a 5-year comparative cohort study
  1. Elizabeth Ratcliffe1,2,
  2. James Britton3,
  3. Harika Yalamanchili1,
  4. Izabela Rostami1,
  5. Syed Mujtaba Hasnain Nadir1,
  6. Mohamed Korani1,
  7. Ikedichukwu Eruchie1,
  8. Muhammad Awais Wazirdin1,
  9. Neeraj Prasad1,
  10. Shaheen Hamdy2,3,
  11. John McLaughlin2,3,
  12. Yeng Ang2,3
  1. 1 Gastroenterology department, Wrightington Wigan and Leigh NHS Foundation Trust, Wigan, UK
  2. 2 Division of Diabetes, Endocrinology and Gastroenterology Faculty of Biology, Medicine and Health School of Medical Sciences, University of Manchester, Manchester, UK
  3. 3 Gastroenterology department, Northern Care Alliance NHS Trust, Salford, UK
  1. Correspondence to Dr Elizabeth Ratcliffe, Gastroenterology department, Wrightington Wigan and Leigh NHS Foundation Trust, Wigan,WN6 9EP, UK; elizabeth.ratcliffe{at}wwl.nhs.uk

Abstract

Objective Barrett’s oesophagus (BO) endoscopic surveillance is performed to varying quality, dedicated services may offer improved outcomes. This study compares a dedicated BO service to standard care, specifically dysplasia detection rate (DDR), guideline adherence and use of advanced imaging modalities in a non-tertiary setting.

Design/method 5-year retrospective comparative cohort study comparing a dedicated BO endoscopy service with surveillance performed on non-dedicated slots at a non-tertiary centre in the UK. All adult patients undergoing BO surveillance between 1 March 2016 and 1 March 2021 were reviewed and those who underwent endoscopy on a dedicated BO service run by endoscopists with training in BO was compared with patients receiving their BO surveillance on any other endoscopy list. Endoscopy reports, histology results and clinic letters were reviewed for DDR and British society of gastroenterology guideline adherence.

Results 921 BO procedures were included (678 patients). 574 (62%) endoscopies were on a dedicated BO list vs 348 (38%) on non-dedicated.

DDR was significantly higher in the dedicated cohort 6.3% (36/568) vs 2.7% (9/337) (p=0.014). Significance was sustained when cases with indefinite for dysplasia were excluded: 4.9% 27/533 vs 0.9% 3/329 (p=0.002). Guideline adherence was significantly better on the dedicated endoscopy lists.

Factors associated with dysplasia detection in regression analysis included visible lesion documentation (p=0.036), use of targeted biopsies (p=<0.001), number of biopsies obtained (p≤0.001).

Conclusions A dedicated Barrett’s service showed higher DDR and guideline adherence than standard care and may be beneficial pending randomised trial data.

  • DYSPLASIA
  • ENDOSCOPY
  • BARRETT'S OESOPHAGUS
  • BARRETT'S METAPLASIA
  • GASTROINTESINAL ENDOSCOPY

Data availability statement

Data are available on reasonable request.

https://doi.org/10.1136/flgastro-2023-102425

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available on reasonable request.

    View Full Text

    Footnotes

    • Twitter @lil_ratcliffe

    • Contributors Conception and design: ER, JB, SH, JM, NP and YA devised the concept of the study. Analysis and interpretation of the data: ER, HY, IR, SMHN, MK, IE and MA performed the screening and data collection, ER performed the statistical analysis of the data with input from JB, YA, JM, SH and NP. Drafting of the article: ER produced the initial draft of the manuscript. Critical revision of the article for important intellectual content and final approval of the article: all authors contributed to and revised the final version of the manuscript. YA is the guarantor for the overall content and accepts full responsibility for the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests ER and YA have research funding from Medtronic, YA has research funding from Cancer Research UK. ER has received honoraria for a podcast recording with Janssen and for a focus group with Takeda. SH is the director and chief scientific officer for Phagenesis and holds founder shares, he holds a patent for Anisys Go and Lyft devices and received honoraria for ESSD meeting Brussels and Chinese Dysphagia research forum.

    • Provenance and peer review Not commissioned; externally peer reviewed.