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Current and Future Status for Evaluation of Dysplasia and Carcinoma in IBD

  • Inflammatory Bowel Disease (G Lichtenstein, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Opinion statement

Endoscopic surveillance is an important method to identify colorectal neoplasia in patients with inflammatory bowel disease. Advances in endoscopic techniques using pancolonic chromoendoscopy have improved the detection of dysplasia compared to white-light endoscopy, which has the potential to decrease the risk of colorectal cancer. Currently, pancolonic chromoendoscopy is readily available for use, and in the future, it will likely become the standard of care for endoscopic surveillance. Pancolonic chromoendoscopy followed by confocal laser endomicroscopy may further increase the yield on surveillance endoscopy, although confocal laser endomicroscopy is not readily available outside of a limited number of institutions. Other endoscopic tools such as narrow band imaging have not been shown to be beneficial over white-light endoscopy. Emerging tools such as stool DNA testing show promise as an adjunct to colonoscopy but are still in the early stages of development. For management, patients with well-demarcated circumscribed dysplastic lesions should be resected endoscopically, followed by a continued endoscopic surveillance program. Patients with lesions that cannot be resected completely or that have features suggestive of invasive carcinoma on either endoscopy or histology should undergo colectomy. Patients with flat high-grade dysplasia should undergo colectomy. Patients with flat low-grade dysplasia should have a discussion about the risks and benefits of undergoing colectomy versus continuing in an endoscopic surveillance program. If they opt for surveillance, these patients should have more frequent follow-up surveillance examinations (every 3 to 6 months) with pancolonic chromoendoscopy.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Conflict of Interest

Joann Kwah and Francis A. Farraye declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Section of Gastroenterology, Boston Medical Center, 85 East Concord Street, 7th Floor, Boston, MA, 02118, USA

    Joann Kwah MD & Francis A. Farraye MD, MSc

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  1. Joann Kwah MD
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  2. Francis A. Farraye MD, MSc
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Correspondence to Francis A. Farraye MD, MSc.

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Kwah, J., Farraye, F.A. Current and Future Status for Evaluation of Dysplasia and Carcinoma in IBD. Curr Treat Options Gastro 12, 90–102 (2014). https://doi.org/10.1007/s11938-013-0006-3

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