Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website https://gr.elmerpub.com

Original Article

Volume 18, Number 5, October 2025, pages 254-261

Histologic Assessment in Ulcerative Colitis: A Survey of Pathologists’ Practices and Perspectives

Figures

Figure 1.
Figure 1. Survey responses regarding the use of standardized histologic indices for ulcerative colitis histologic activity assessment in routine practice. (a) Proportion of respondents reporting the use of any standard histologic index in routine pathology reporting (question 20, Supplementary Material 1, gr.elmerpub.com). (b) Distribution of specific histologic indices used among those who answered “yes” to panel (a).
Figure 2.
Figure 2. Distribution of responses among surveyed pathologists (N = 57) regarding the score thresholds they associate with histologic remission for three common histologic indices used in the assessment of colonic biopsies from ulcerative colitis patients: (a) Nancy Index, (b) Robarts Histopathology Index, and (c) Geboes Score. The “do not know” represents the percentage of respondents unfamiliar with the appropriate threshold for histologic remission for each index/scoring system.
Figure 3.
Figure 3. Heatmap showing pathologists’ responses to knowledge assessment questions on histologic features of inflammatory bowel disease. Participants rated their level of agreement with each statement using a five-point Likert scale: strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, and strongly disagree. The heatmap shows the percentage of respondents selecting each category for statements related to features of chronicity, diagnostic markers, and normal histologic findings in the colon in inflammatory bowel disease.

Table

Table 1. Demographics and Practice Characteristics of the Survey Participants (N = 57)
 
CharacteristicNumber of participants (%)
IBD: inflammatory bowel disease.
Practice location
  United States of America43 (75.4)
  Canada7 (12.3)
  Europe and the United Kingdom4 (7.0)
  Australia1 (1.7)
  Brazil1 (1.7)
  Other (not specified)1 (1.7)
Practice type
  University Academic Center34 (59.6)
  Community Hospital9 (15.8)
  Private Practice9 (15.8)
  Others5 (8.8)
Training background
  Gastrointestinal Pathology Fellowship52 (91.2)
  General Surgical Pathology/other Fellowship5 (8.8)
Years in practice
  > 10 years36 (63.2)
  5 - 10 years13 (22.8)
  < 5 years8 (14.0)
Average weekly biopsy volume from IBD patients
  > 20 cases/sets of biopsies17 (29.8)
  10 - 19 cases/sets of biopsies18 (31.6)
  5 - 9 cases/sets of biopsies16 (28.1)
  1 - 4 cases/sets of biopsies6 (10.5)
Indication for biopsies at site of practice
  Both initial diagnosis and monitoring50 (87.7)
  Monitoring alone6 (10.5)
  Initial diagnosis alone1 (1.8)
Participation in a multidisciplinary IBD conference
  No34 (59.6)
  Yes23 (40.4)