Abstract Background Patients with inflammatory bowel disease (IBD) are at 1.4-1.7 times increased risk of developing colorectal cancer (CRC) compared with the non-IBD population. Clinical guidelines recommend regular colonoscopic surveillance to detect and manage colitis-associated dysplasia or early-stage CRC.1 Despite its importance, colonoscopy ranks low in acceptability among IBD patients when compared to other disease monitoring procedures.2 Adherence to surveillance varies3 and patients’ experiences are poorly understood. This study aimed to address the question: “What are the experiences of adult patients with IBD regarding colonoscopic surveillance programmes for colitis-associated dysplasia and CRC?”. The objectives were to explore patients’ experiences of surveillance and identify barriers and motivators influencing participation. Methods This mixed-methods systematic review (MMSR) was conducted in alignment with the Joanna Briggs Institute methodology, using a convergent segregated mixed-methods design. The PRISMA diagram (Figure 1) summarises the search and studies selection. Data were extracted using a standardised tool and appraised with Critical Appraisal Skills Programme checklists. Quantitative findings were synthesised descriptively, and qualitative findings underwent thematic synthesis before final integration. Results Three studies met the inclusion criteria (two cross-sectional surveys and one qualitative interview study), performed in the UK (n = 1) and the USA (n = 2). Key qualitative and quantitative findings are summarised in Table 1. The barriers to surveillance spanned 5 themes: 1) bowel preparation difficulties, 2) understanding the procedure’s purpose, 3) poor clinician communication, 4) emotional responses, e.g. anxiety, and 5) logistical constraints. Motivating factors included clear explanations from clinicians, reassurance about disease status, and confidence in the benefits of surveillance. Conclusion This review provides a deeper understanding of how patients experience and interpret the surveillance process, highlighting modifiable factors that could enhance engagement. The five identified themes raise awareness that many barriers are easily remediable. Measures to remove barriers may improve the patient experience and thereby increase the uptake of surveillance to mitigate the risk of CRC. This MMSR demonstrates that research in this area remains limited and highlights the need for further research. References: 1. East JE, Gordon M, Nigam GB, et al. British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease. Published online April 30, 2025. doi:10.1136/gutjnl-2025-335023Inflamm Bowel Dis. 2017;23(8):1425-1433. doi:10.1097/MIB.0000000000001140J Crohns Colitis. 2024;18(5):686-694. doi:10.1093/ecco-jcc/jjad189 2. Buisson A, Gonzalez F, Poullenot F, et al. Comparative Acceptability and Perceived Clinical Utility of Monitoring Tools: A Nationwide Survey of Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis. 2017;23(8):1425-1433. doi:10.1097/MIB.0000000000001140 3. Kabir M, Thomas-Gibson S, Ahmad A, et al. Cancer Biology or Ineffective Surveillance? A Multicentre Retrospective Analysis of Colitis-Associated Post-Colonoscopy Colorectal Cancers. J Crohns Colitis. 2024;18(5):686-694. doi:10.1093/ecco-jcc/jjad189 Conflict of interest: Dr. Murray, Jennifer: No conflict of interest Fadra, Adam: None to declare Czuber-Dochan, Wladyslawa: Grant: National Institute of Health Research, Bristol Myers Squibb, and Crohn’s and Colitis UK Personal Fees: Dr Falk Pharma UK and PharmaCosmos Misra, Ravi: No conflict of interest Arebi, Naila: Personal Fees: Janssen,Lilly, Pfizer and Takeda Non-financial Support: Janssen (J & J), Novonesis Table 1: Summary of main findings
Murray et al. (Thu,) studied this question.