Chromoendoscopy May Improve Dysplasia Detection in IBD

Procedure targets changes in the mucosa that might indicate colorectal cancer among patients with inflammatory bowel disease.

Researchers recently discovered a superior method to detect dysplasia in inflammatory bowel disease (IBD) patients.

Typically, physicians use white light colonoscopy, non-targeted biopsies, targeted sampling, and the removal of lesions for mucosal abnormalities. However, researchers believe there are other methods that are more promising in detection.

Chromoendoscopy is a medical procedure that uses dyes in the gastrointestinal tract to locate unusual changes in the mucosa that might indicate colorectal cancer.

"While there has been a growing consensus on the superiority of chromoendoscopy compared to other dysplasia surveillance methods over the last decade, these results are the first to demonstrate this superiority through long-term surveillance," said study lead James F. Marion, MD.

Since IBD patients are at risk for developing colorectal cancer, it’s important to accurately detect dysplasia.

The single blinded study evaluated 208 patients from June 2006 through October 2011, who were analyzed by random biopsy, targeted white-light examination, and chromoendoscopy.

The results showed 44 dysplastic lesions in 24 patients. Six were found from a random biopsy, 11 through white-light examination, and 27 from a chromoendoscopy. Ten patients were referred for a colectomy, the full or partial removal of the colon, and no carcinomas were found.

"Despite the abundant evidence supporting improved dysplasia detection in patients with IBD through chromoendoscopy screening and its incorporation into our guidelines, many gastroenterologists continue to rely on expensive random biopsies for detection of dysplasia and colorectal cancer," Dr. Marion said. "We hope these long-term findings resonate throughout the GI community and prompt screening changes, thus improving patient outcomes. Chromoendoscopy is an inexpensive, easy-to-learn technique that allows us to manage our patients without surgery. Our current guidelines will need to be revisited."