P0499Quality of Colonoscopy in Hungarian IBD Centers at Different Care Levels: How Well Do We Follow ESGE Recommendations?

Background High-quality endoscopy in inflammatory bowel disease (IBD) is associated with improved clinical outcomes and forms the basis for quality assurance. The European Society of Gastrointestinal Endoscopy (ESGE) recommends nine key performance measures for quality control in IBD-related colonoscopy. This study aimed to compare colonoscopy quality indicators in IBD across different levels of care. Methods In this nationwide cross-sectional study, we analyzed colonoscopy reports of patients with IBD. We consecutively enrolled patients over 18 years old with established IBD between January and October 2025, using their available colonoscopy reports. The tertiary care group included colonoscopy reports from the most recent complete colonoscopy performed at tertiary IBD centers in Pécs, Budapest, and Szeged. The secondary care group included the most recent colonoscopy reports performed at secondary care institutions for patients later referred to tertiary centers, based on estimated sample size. Nine key performance measures (indication, bowel preparation, photo documentation, ileal intubation, biopsy, endoscopic activity score, high-definition and chromoendoscopy use, and neoplasia detection) were evaluated, while. patients were also analyzed according to the indication for colonoscopy (diagnostic, disease activity assessment, or surveillance). Results A total of 397 colonoscopy reports were evaluated, of which 158/397 were performed in secondary care, while 51.4% of patients had Crohn’s disease. Disease activity assessment (91% vs. 55%, p < 0.001), surveillance procedures (1.4% vs. 0%), and biopsy sampling in the number and location according to the recommendations (81% vs. 65%, p < 0.001) were more frequently performed in tertiary centers. Documentation of Boston Bowel Preparation Scale was more frequent in tertiary centers (97.1% vs. 55%; p < 0.001). Use of endoscopic activity scoring systems was also higher in tertiary care (51.9% vs. 14.0%; p < 0.001), as was ileal intubation (65% vs. 43%; p < 0.001). Withdrawal and total procedure times did not differ significantly between levels, and surveillance procedures were not assessed in this analysis. Conclusion The performance of colonoscopy quality indicators remains below guideline-recommended targets; however, results were consistently higher at the tertiary care level. Targeted educational initiatives led by national and international societies are needed to support gastroenterologists in improving colonoscopy quality in IBD. References: 1. Dekker E, Nass KJ, Iacucci M, et al. Performance measures for colonoscopy in inflammatory bowel disease patients: European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy. 2022;54(9):904-915. doi:10.1055/a-1874-0946 2. With the exception of language editing, no AI-assisted technologies were used in the production of the submitted abstract. Conflict of interest: Dr. Bacsur, Péter: No conflict of interest Suhajda, Ákos: No conflict of interest Farkas, Bernadett: No conflict of interest Gálfalvi, Noémi: No conflict of interest. Pápista, Máté: I have no Conflict of interest: to declare. Sarlós, Patrícia: No conflict of interest Ilias, Akos: No conflict of interest Gonczi, Lorant: No conflict of interest Ivány, Emese: No conflict of interest Farkas, Klaudia: No conflict of interest Molnár, Tamás: Conflict of interest: Tamás Molnár has received speaker’s honoraria from MSD, AbbVie, Egis, Goodwill Pharma, Takeda, Pfizer, Janssen, Sandoz, Phytotec, Roche, Fresenius, Teva, Celltrion, Stada, BMS, Ferring, EwoPharma and SOBI