Management of cystic echinococcosis in British Columbia: outcomes and suggestions to improve guideline adherence

Summary Cystic echinococcosis (CE) is rare in Canada but continues to appear sporadically, sometimes in patients who have not travelled to endemic regions. Since 2010, World Health Organization (WHO) guidelines have emphasized stage-specific management, yet the extent to which this approach is applied in Canadian practice is uncertain. We reviewed 41 cases of CE managed in British Columbia between 2010 and 2022; only about two-thirds received treatment aligned with WHO guidance. The primary gap was in radiology reporting, which frequently documented cyst size but omitted the staging details essential for surgical decision-making. Although outcomes were generally favourable, the lack of standardized pathways led to unnecessary clinical variation. Structured radiology reporting, multidisciplinary oversight and provincial collaboration remain essential to ensure consistent, evidence-based care, especially for rare diseases where experience is limited.