P247 Understanding patient perspectives on dysplasia cancer risk and its management
M. Kabir*1,2, S. Thomas-Gibson1,2, A. Hart1,2, O. Faiz1,2, J. Warusavitarne1,2, A. Wilson1,2
1St Mark's Hospital, London, UK, 2Imperial College, London, UK
Uncertainty in inflammatory bowel disease (IBD) dysplasia prognosis makes management decision-making challenging. Further understanding of patient preferences is required to help clinicians support this process.
A web survey, evaluating views on dysplasia, was administered via IBD charity social media in November 2018, to UK IBD patients who have had colorectal cancer (CRC) surveillance. Validated scores assessed whether their decisions were influenced by concerns about developing CRC (Cancer Worry Scale, CWS), their dispositional optimism (revised Life Orientation Test, LOT-R), numerical ability (Subjective Numeracy Scale, SNS) and health-related quality of life (Short IBD Questionnaire, SIBDQ).
There were 50 respondents (see Table 1). Being told that a dysplastic lesion was ‘high risk’ or ‘low risk’ in words, corresponded with a mean perceived risk of 56% and 17%, respectively. Of the patients who were dysplasia-naïve (
|IBD type||Ulcerative colitis: |
|Mean age||55 years|
|Mean duration of IBD colitis||22 years|
|Reported flares requiring steroids in last year|
|Respondents who believe their chance of getting CRC in their lifetime is 0–10%|
|Respondents who identified dysplasia as a risk factor for cancer|
|Respondents who believe endoscopic resection of dysplasia STOPS patients from getting colorectal cancer|
|Mean Short IBD Questionnaire score (min. score 1; max score 7)||4.9|
|Mean Cancer Worry Scale score (min. score 6; max score 24)||9.8|
This survey has suggested that about a quarter of IBD dysplasia patients did not feel well informed about their cancer risks and management. Further qualitative work is required to understand how best to support shared decision-making in IBD dysplasia.