PreCeDenT: Patient Priorities in Cancer and Dysplasia Treatment in IBD
Research type
Research Study
Full title
Eliciting treatment preferences for management options for dysplasia and cancer in patients with Inflammatory Bowel Disease – a Discrete Choice Experiment (DCE)
IRAS ID
321051
Contact name
Amira Shamsiddinova
Contact email
Sponsor organisation
London North West University Healthcare NHS Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
It is recognised that patients with Inflammatory Bowel Disease are at an increased risk of developing colorectal cancer (CRC) compared to the general population. This is thought to happen because of the ongoing damage to the lining of the bowel from inflammation that leads to precancerous changes (dysplasia). The exact risk of dysplasia becoming a cancer is still unclear, and depends on its type (High grade, Low grade, multifocal). The current evidence base is largely outdated and is of low quality. In addition, the technology to detect dysplasia and CRC is constantly improving, and in recent decades better surveillance practices have been adopted, and newer treatments for inflammatory bowel disease have been introduced. International guidelines recommend that patients who are found to have CRC or high grade dysplasia have surgery to remove the whole large bowel and back passage, or if the dysplasia is low grade that this operation is discussed with them. In patients whose Inflammatory Bowel Disease only affects their large bowel(Ulcerative Colitis, Crohn's colitis), this type of operation would also serve as a cure for their condition. However many patients are unwilling to undergo this major life-changing surgery with the possibility of a permanent stoma for risks (of cancer) that they perceive to be low. Many ask why just the problematic section of the colon could not be removed (segmental colectomy). There is limited data about the outcomes from segmental colectomy, and research is ongoing. The purpose of this study is to clarify the most important factors and trade offs that patients with IBD at risk of dysplasia and CRC take into account when making a decision about surgery. Ultimately this will help establish if the risks of segmental colectomy would be acceptable to patients, and if so, which patient groups it would benefit most.
REC name
West Midlands - Solihull Research Ethics Committee
REC reference
23/WM/0003
Date of REC Opinion
6 Feb 2023
REC opinion
Further Information Favourable Opinion