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World J Gastrointest Endosc. Oct 16, 2018; 10(10): 250-258
Published online Oct 16, 2018. doi: 10.4253/wjge.v10.i10.250
Screening and surveillance methods for dysplasia in inflammatory bowel disease patients: Where do we stand?
Michail Galanopoulos, Emmanouela Tsoukali, Filippos Gkeros, Marina Vraka, Georgios Karampekos, Gerassimos J Matzaris
Michail Galanopoulos, Emmanouela Tsoukali, Filippos Gkeros, Marina Vraka, Georgios Karampekos, Gerassimos J Matzaris, Department of Gastroenterology, Evangelismos, Ophthalmiatreion Athinon and Polyclinic Hospitals, Athens 10676, Greece
Author contributions: Galanopoulos M designed the review; Galanopoulos M, Gkeros F, Tsoukali E, Karampekos G and Vraka M analyzed and interpreted the data; Galanopoulos M and Matzaris GJ drafted the manuscript; Matzaris GJ critically revised the paper.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Michail Galanopoulos, MD, Doctor, Department of Gastroenterology, Evangelismos, Ophthalmiatreion Athinon and Polyclinic Hospitals, 45-47 Ypsilantou Street, Kolonaki, Athens 10676, Greece. galanopoulosdr@gmail.com
Telephone: +30-21-32041609 Fax: +30-21-32041989
Received: May 29, 2018
Peer-review started: May 29, 2018
First decision: June 6, 2018
Revised: June 24, 2018
Accepted: June 28, 2018
Article in press: June 29, 2018
Published online: October 16, 2018
Abstract

Patients with long-standing ulcerative colitis (UC) and extensive Crohn’s colitis (CC) are at increased risk for dysplasia and colorectal cancer (CRC). Several studies have shown that UC extending proximal to the rectum, CC involving at least 1/3 of the colon, co-existence of primary sclerosing cholangitis, undetermined or unclassified colitis, family history of CRC and young age at diagnosis appear to be independent risk factors for inflammatory bowel disease (IBD) - related CRC. Therefore, screening and surveillance for CRC in IBD patients is highly recommended by international and national guidelines, whilst colonoscopy remains the unequivocal tool in order to detect potentially resectable dysplastic lesions or CRC at an early stage. Although the importance of screening and surveillance is widely proven, there is a controversy regarding the time of the first colonoscopy and the criteria of who should undergo surveillance. In addition, there are different recommendations among scientific societies concerning which endoscopic method is more efficient to detect dysplasia early, as well as the terminology for reporting visible lesions and the management of those lesions. This article concisely presents the main endoscopic methods and techniques performed for detecting dysplasia and CRC surveillance in patients with IBD focusing on their evidence-based accuracy and efficiency, as well as their cost-effectiveness. Finally, newer methods are mentioned, highlighting their applicability in daily endoscopic practice.

Keywords: Inflammatory bowel disease, Ulcerative colitis, Crohn’s disease, Dysplasia, Colorectal cancer, Endoscopy, Chromoendoscopy, Surveillance

Core tip: There is an established association between inflammatory bowel disease (IBD) and colorectal cancer (CRC). Therefore, surveillance of these patients for CRC is crucial and recommended by international guidelines. In this review we present the main endoscopic methods and techniques performed for detecting dysplasia and CRC surveillance in patients with IBD, highlighting chromoendoscopy with targeted biopsies as the gold standard method. Finally, newer methods are mentioned, examining their applicability in daily endoscopic practice.