Colorectal Cancer Surveillance in Patients with Inflammatory Bowel Diseases: Chromoendoscopy or Non-Chromoendoscopy, That Is the Question.

Roberto Gabbiadini,Mariangela Allocca,Federica Furfaro,Gionata Fiorino,Maria Terrin,Ferdinando D’Amico,Alessandra Zilli,Alessandro De Marco,Silvio Danese

doi:10.3390/jcm11030509

Abstract

Subjects affected by ulcerative colitis and Crohn’s disease with colonic localization have an increased risk of colorectal cancer (CRC). Surveillance colonoscopy is recommended by international guidelines as it can detect early-stage CRC. Based on previous evidence, in 2015 the Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients International Consensus indicated dye chromoendoscopy (DCE) as the most effective technique for detecting dysplasia. However, advances in endoscopic technology such as high-definition colonoscopes and dye-less virtual chromoendoscopy (VCE) may change future practice. In this review, we summarize the available evidence on CRC surveillance in IBD, focusing on the emerging role of high-definition white light endoscopy (HD-WLE) and VCE over the standard DCE, and the current role of random biopsies.

Highlights

Inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn’s disease (CD), are life-long disorders characterized by chronic relapsing inflammation of the gastrointestinal tract [1,2]
We summarize the available evidence on colorectal cancer (CRC) surveillance in IBD, focusing on the emerging role of high-definition white light endoscopy (HD-WLE) and virtual chromoendoscopy (VCE) over the standard dye chromoendoscopy (DCE), and the current role of random biopsies
We aimed to summarize the available evidence in the continuous expanding scenario of CRC surveillance in IBD since the SCENIC consensus published in 2015, focusing on the emerging role of HD-WLE and VCE over the standard DCE, and the current role of random biopsies

Summary

Introduction

Inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn’s disease (CD), are life-long disorders characterized by chronic relapsing inflammation of the gastrointestinal tract [1,2]. The scenario of CRC surveillance in IBD has become more tricky with the development of the dye-less, virtual chromoendoscopy (VCE) This technology has emerged as a valid contrast enhancement system without dye application, being less time-consuming and less expensive than DCE [28,29]. By pushing a button, VCE provides an instant digital staining, enhancing colonic mucosal details and vascularization [24,29] Such groundbreaking novelties have risen concern about the position of HD-WLE, DCE, or VCE as the future preferred method for surveillance [29] and about the benefit of random biopsies in this era of constant advancing image technology [20]. We aimed to summarize the available evidence in the continuous expanding scenario of CRC surveillance in IBD since the SCENIC consensus published in 2015, focusing on the emerging role of HD-WLE and VCE over the standard DCE, and the current role of random biopsies

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Methods

Results

Discussion

Conclusion