Title:Unveiling Cancer in IBD: Screening Colonoscopy or Chromoendoscopy
Volume: 13
Issue: 10
Author(s): Alessandro Repici, Maria Antonella Laterra, Fabio Cisaro, Rinaldo Pellicano, Lucia Fini and Sauid Ishaq
Affiliation:
Keywords:
Cancer, screening, IBD, colonoscopy, chromoendoscopy, inflammatory disorders, Crohn's disease, ulcerative colitis, colorectal cancer (CRC), uncontrolled chronic activation.
Abstract: The risk of developing colorectal cancer (CRC) is increased in patients with inflammatory bowel disease
(IBD), particularly if the disease is extensive and its duration long-standing. Endoscopic guidelines have been developed
with the goal of detecting early neoplastic changes prior to development of advanced malignancy. The current surveillance
strategy of surveillance colonoscopy, with multiple random biopsies, most likely reduces morbidity and mortality
associated with IBD-related CRC. Unfortunately, standard surveillance colonoscopy also has limitations, including high
cost and sampling error at time of biopsy. The main issue is that colitis associated neoplasms often occur in flat mucosa of
normal appearance, and are detected on taking random biopsies rather than by direct identification of these lesions via endoscopic
imaging. Advances in endoscopic imaging techniques, such as vital or optical chromoendoscopy, that can enhance
mucosal characteristics, may potentially aid in increasing dysplasia detection rate, and may reduce the workload of
standard random biopsies. The aim of this review was to describe and summarize outcomes of more advanced endoscopic
imaging techniques, including chromoendoscopy and magnification endoscopy.
