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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EPatients with inflammatory bowel disease are at an increased risk of developing colorectal cancer. These patients should undergo surveillance colonoscopy for detection of dysplasia or adenoma. Studies have demonstrated that chromoendoscopy is the most effective technique for detection of dysplasia in this population.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Einflammatory bowel disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EIBD\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECrohn disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eulcerative colitis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecolonoscopy\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Echromoendoscopy\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecolorectal cancer\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Egastroenterology clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EPatients with inflammatory bowel disease (IBD) are associated with higher rates of colorectal cancer (CRC) as compared with patients without IBD [Wang YR et al. \u003Cem\u003EAm J Gastroenterol\u003C\/em\u003E. 2013]. As a result, patients with IBD should undergo CRC surveillance. A recent study demonstrated that patients with ulcerative colitis (OR, 3.05; 95% CI, 2.44 to 3.81) or Crohn disease (OR, 3.07; 95% CI, 2.23 to 4.21) were at the greatest risk of having missed CRC when compared with patients without IBD [Wang YR et al. \u003Cem\u003EAm J Gastroenterol\u003C\/em\u003E. 2013]. A greater proportion of stage III\/IV CRC was missed in patients with Crohn disease vs patients with ulcerative colitis or without IBD.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ETonya Kaltenbach, MD, MS, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA, showed that these data highlight the importance of successful surveillance for CRC in patients with IBD. Successful surveillance is dependent on recognition of dysplasia, adequacy of sampling, potential interfering anatomy, endoscopic resectability, and patient compliance with surveillance.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EA 2004 study of \u0026gt;\u20052000 colonoscopies demonstrated that most dysplastic lesions are endoscopically visible. Subsequently, the 2015 SCENIC international consensus statement on the surveillance and management of dysplasia in IBD recommended that surveillance for CRC be performed with high-definition chromoendoscopy with targeted biopsy [Laine L et al. \u003Cem\u003EGastrointest Endosc\u003C\/em\u003E. 2015]. In addition, the consensus statement recommended against electronic-based image-enhanced endoscopy. This statement was based on data from 8 studies of \u0026gt;\u2005700 patients with IBD demonstrating that chromoendoscopy was favored over white-light standard-definition endoscopy for the detection of dysplasia and adenomas. In this study, the incremental yield of dysplasia using chromoendoscopy was 6% (95% CI, 2.8% to 9.2%).\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EPan- vs targeted chromoendoscopy is used for different purposes (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E) [Laine L et al. \u003Cem\u003EGastrointest Endosc\u003C\/em\u003E. 2015]. In panchromoendoscopy, white light is used to visualize diluted indigo carmine image-enhanced endoscopy to detect lesions. For diagnosis, targeted chromoendoscopy uses a more concentrated solution of indigo carmine to visualize the surface pattern of the lesion. Abnormalities such as slightly elevated lesions, focal friability, obscure vascular patterns, uneven discoloration, villous mucosa, and irregular nodularity indicate a need for tissue sampling [Soetikno R et al. \u003Cem\u003EGastrointest Clin N Am\u003C\/em\u003E. 2014].\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16791\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16791\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16791\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003ETo allow visualization of dysplastic abnormalities, it is important that any active IBD is treated prior to surveillance. In addition, the bowel must be properly prepared since remaining wash residue can obstruct the view. The presence of pseudopolyps or strictures can also complicate detection.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EIn conclusion, Dr Kaltenbach pointed out that in patients with IBD, the traditional method of obtaining random tissue samples to detect dysplasia is no longer sufficient and, instead, vital stain chromoendoscopy with targeted tissue sampling should be used.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/14\/21.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlhre\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzlhre\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}