Random versus targeted biopsies for colorectal cancer surveillance in inflammatory bowel disease

For many years, cancer surveillance colonoscopy in ulcerative colitis patients has involved obtaining at least 30 biopsies of flat and abnormal-appearing mucosa. With the advent of better imaging techniques, biopsies can be better targeted to abnormal-appearing mucosa, thereby increasing the sensitivity of testing. Use of chromoendoscopy, narrow-band imaging, autofluorescence, or confocal endomicroscopy to target biopsies is likely to improve detection of dysplasia and identification of patients at high risk for developing cancer.