Editorial
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Nov 16, 2018; 10(11): 322-325
Published online Nov 16, 2018. doi: 10.4253/wjge.v10.i11.322
Screening for colorectal cancer in patients with inflammatory bowel disease. Should we already perform chromoendoscopy in all our patients?
Jose María Huguet, Patrícia Suárez, Luis Ferrer-Barceló, Isabel Iranzo, Javier Sempere
Jose María Huguet, Patricía Suárez, Luis Ferrer-Barceló, Isabel Iranzo, Javier Sempere, Digestive Disease Department, Hospital General Universitario de Valencia, Valencia 46014, Valencia, Spain
Author contributions: Huguet JM, Suárez P, Ferrer-Barceló L, Iranzo I and Sempere J conceived the study and drafted the manuscript. All authors contributed to and approved the final version of the manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to report.
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: Jose María Huguet, PhD, Assistant Professor, Digestive Disease Department, Hospital General Universitario de Valencia, Avenida Tres Cruces 2, Valencia 46014, Valencia, Spain. huguet_jos@gva.es
Telephone: +34-60-6394982 Fax: +34-96-3131901
Received: July 5, 2018
Peer-review started: July 5, 2018
First decision: August 2, 2018
Revised: August 4, 2018
Accepted: October 10, 2018
Article in press: October 10, 2018
Published online: November 16, 2018
Abstract

Patients with inflammatory bowel disease (commonly known as IBD) have a greater risk of colorectal cancer than the general population. Therefore, they are included in special programs for screening and follow-up. Chromoendoscopy, which has a high diagnostic yield in the detection of neoplasia, is generally the recommended endoscopy technique. However, this procedure does have some disadvantages (long examination time, need for optimal bowel preparation, specialist training), which increase its cost. How then can we overcome these barriers? First, it is necessary to educate hospital managers and directors of the advantages of chromoendoscopy in patients with IBD. Second, at least one endoscopist per center should be a specialist in the technique. Third, we should train nursing staff in the preparation of the dye. Finally, each examination should be given the time it needs. Even though clinical practice guidelines do not yet recommend the use of virtual imaging techniques such as narrow band imaging, a recent study reported no differences between the two approaches for the detection of tumors. Therefore, we believe that all patients should undergo chromoendoscopy. In the future, centers without access to dyes or where other barriers exist should at least perform narrow band imaging.

Keywords: Colorectal Cancer, Inflammatory bowel disease, Chromoendoscopy, Surveillance, Narrow band imaging

Core tip: Patients with inflammatory bowel disease are included in special programs for screening and follow-up of colorectal cancer. It is generally recommended that endoscopy be performed using chromoendoscopy, which has a high diagnostic yield for detection of the disease. However, chromoendoscopy does have a series of disadvantages. While some clinical practice guidelines do not yet recommend the use of virtual imaging techniques such as narrow band imaging, a recent study reported that there were no differences between the two approaches for detection of neoplastic lesions. Therefore, we recommend that all inflammatory bowel disease patients undergo chromoendoscopy.