Chromoendoscopy for colorectal cancer surveillance in patients with inflammatory bowel disease

Chromoendoscopy utilizes colorimetric techniques to increase detection of lesions that are difficult to see or cannot be seen with conventional white light endoscopy. Multiple studies have demonstrated that chromoendoscopy with dye spraying significantly increases the detection of dysplastic lesions in patients with chronic inflammatory bowel disease (IBD) of the colon undergoing colonoscopy. Furthermore, chromoendoscopy may obviate the need for random biopsies and pending additional studies and may allow increased intervals between surveillance exams, reducing costs while increasing the sensitivity for detection of dysplasia per exam. Despite convincing data supporting the use of chromoendoscopy for IBD colonic surveillance, it is seldom utilized outside of academic centers. Here, we review the current approach to colorectal cancer surveillance in IBD focusing on the data supporting the use of chromoendoscopy including its use in a community setting and offer practical recommendations for incorporating chromoendoscopy as a routine part of surveillance in IBD regardless of practice setting.