Endoscopic evaluation for colon cancer and dysplasia in patients with inflammatory bowel disease

Certain patients with inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer, and surveillance is recommended to detect dysplasia and early neoplasia. Endoscopic techniques that screen large mucosal surface areas for potential areas of interest that have been studied in IBD surveillance include dye-based surface chromoendoscopy with methylene blue or indigo carmine, dye-less chromoendoscopy including narrow-band imaging, i-scan, Fujinon intelligent chromoendoscopy, and autofluorescence imaging. Literature to date supports the use of surface chromoendoscopy with either methylene blue or indigo carmine to maximize dysplasia detection. Characterization of detected lesions may be further enhanced with optical biopsy technology, including confocal laser endomicroscopy and endocystoscopy, that allows in vivo histologic diagnosis that may guide both diagnosis and therapy of detected dysplastic lesions. Current and future endoscopic approaches for optimizing screening and surveillance of colon cancer and dysplasia in patients with IBD are reviewed.