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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(10): E952-E962
DOI: 10.1055/a-2125-0161
Original article

Adherence to guideline recommendations for Barrett's esophagus (BE) surveillance endoscopies: Effects of dedicated BE endoscopy lists

I.N. Beaufort
1   Department of Gastroenterology and Hepatology, Sint Antonius Ziekenhuis, Nieuwegein, Netherlands (Ringgold ID: RIN6028)
2   Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, Netherlands (Ringgold ID: RIN8124)
,
A.N. Milne
3   Department of Pathology, Sint Antonius Ziekenhuis, Nieuwegein, Netherlands (Ringgold ID: RIN6028)
,
Y.A. Alderlieste
4   Department of Gastroenterology and Hepatology, Beatrixziekenhuis, Gorinchem, Netherlands (Ringgold ID: RIN159172)
,
J.E. Baars
5   Department of Gastroenterology and Hepatology, Amphia Ziekenhuis, Breda, Netherlands (Ringgold ID: RIN89411)
,
P.R. Bos
6   Department of Gastroenterology and Hepatology, Ziekenhuis Gelderse Vallei, Ede, Netherlands (Ringgold ID: RIN3096)
,
J.P.W. Burger
7   Department of Gastroenterology and Hepatology, Rijnstate, Arnhem, Netherlands (Ringgold ID: RIN1322)
,
N.C.M. van Heel
8   Department of Gastroenterology and Hepatology, Gelre Ziekenhuizen, Apeldoorn, Netherlands (Ringgold ID: RIN72485)
,
M. Ledeboer
9   Department of Gastroenterology and Hepatology, Deventer Ziekenhuis, Deventer, Netherlands (Ringgold ID: RIN2976)
,
R.J. Lieverse
10   Department of Gastroenterology and Hepatology, Ziekenhuisgroep Twente, Almelo, Netherlands (Ringgold ID: RIN1154)
,
P.C. van de Meeberg
11   Department of Gastroenterology and Hepatology, Slingeland Ziekenhuis, Doetinchem, Netherlands (Ringgold ID: RIN2987)
,
J.J. Meeuse
12   Department of Internal Medicine, Ziekenhuis Rivierenland, Tiel, Netherlands (Ringgold ID: RIN36694)
,
A.H.J. Naber
13   Department of Gastroenterology and Hepatology, Tergooi MC, Hilversum, Netherlands (Ringgold ID: RIN3913)
,
H.J.M. Pullens
14   Department of Gastroenterology and Hepatology, Meander MC, Amersfoort, Netherlands (Ringgold ID: RIN1170)
,
R.C.H. Scheffer
15   Department of Gastroenterology and Hepatology, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, Netherlands (Ringgold ID: RIN10233)
,
M. Sikkema
16   Department of Gastroenterology and Hepatology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, Netherlands (Ringgold ID: RIN7898)
,
R.E. Verbeek
17   Department of Gastroenterology and Hepatology, Groene Hart Ziekenhuis, Gouda, Netherlands (Ringgold ID: RIN3573)
,
M.A.M.T. Verhagen
18   Department of Gastroenterology and Hepatology, Diakonessenhuis Utrecht Zeist Doorn, Utrecht, Netherlands (Ringgold ID: RIN8118)
,
W. van de Vrie
19   Department of Gastroenterology and Hepatology, Albert Schweitzer Ziekenhuis, Dordrecht, Netherlands (Ringgold ID: RIN2998)
,
M. Willems
20   Department of Gastroenterology and Hepatology, Ziekenhuis Sint Jansdal, Harderwijk, Netherlands (Ringgold ID: RIN72496)
,
B.L.A.M. Weusten
1   Department of Gastroenterology and Hepatology, Sint Antonius Ziekenhuis, Nieuwegein, Netherlands (Ringgold ID: RIN6028)
2   Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, Netherlands (Ringgold ID: RIN8124)
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Abstract

Background and study aims For non-dysplastic Barrett’s Esophagus (BE) patients, guidelines recommend endoscopic surveillance every 3 to 5 years with four-quadrant random biopsies every 2 cm of BE length. Adherence to these guidelines is low in clinical practice. Pooling BE surveillance endoscopies on dedicated endoscopy lists performed by dedicated endoscopists could possibly enhance guideline adherence, detection of visible lesions, and dysplasia detection rates (DDRs).

Patients and methods Data were used from the ACID-study (Netherlands Trial Registry NL8214), a prospective trial of BE surveillance in the Netherlands. BE patients with known or previously treated dysplasia were excluded. Guideline adherence, detection of visible lesions, and DDRs were compared for patients on dedicated and general endoscopy lists.

Results A total of 1,244 patients were included, 318 on dedicated lists and 926 on general lists. Endoscopies on dedicated lists showed significantly higher adherence to the random biopsy protocol (85% vs. 66%, P <0.01) and recommended surveillance intervals (60% vs. 47%, P <0.01) compared to general lists. Detection of visible lesions (8.8% vs. 8.1%, P=0.79) and DDRs were not significantly different (6.9% and 6.6%, P=0.94). None (0.0%) of the patients scheduled on dedicated lists and 10 (1.1%) on general lists were diagnosed with esophageal adenocarcinoma (P=0.07). In multivariable analysis, dedicated lists were significantly associated with biopsy protocol adherence and adherence to surveillance interval recommendations with odds ratios of 4.45 (95% confidence interval [CI] 2.07–9.57) and 1.64 (95% CI 1.03–2.61), respectively.

Conclusions Dedicated endoscopy lists are associated with better adherence to the random biopsy protocol and surveillance interval recommendations.

Keywords

Endoscopy Upper GI Tract - Reflux disease - Barrett's and adenocarcinoma - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE)

Supporting information



Publication History

Received: 19 January 2023

Accepted after revision: 19 June 2023

Article published online:
11 October 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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