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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\u003EA small single-center trial showed that high-definition chromoendoscopy improves detection of dysplastic lesions in patients with long-standing ulcerative colitis during screening endoscopy as compared with high-definition white light endoscopy. These results will be confirmed in a larger UK study enrolling 1600 patients.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eulcerative colitis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecolorectal cancer\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Escreening endoscopy\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehigh-definition chromoendoscopy\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehigh-definition white light endoscopy\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Edysplasia\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Egastroenterology clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENCT02138318\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EIndividuals with ulcerative colitis (UC) have an increased risk for colorectal cancer when compared with the general population [Jess T et al. \u003Cem\u003EClin Gastroenterol Hepatol\u003C\/em\u003E. 2012]. Surveillance endoscopy to detect dysplastic lesions is critical in reducing this risk. Image-enhanced endoscopy offers improved resolution and lesion detection during surveillance endoscopy [Subramanian V, Ragunath K. \u003Cem\u003EClin Gastroenterol Hepatol\u003C\/em\u003E. 2014]. Advances in image enhancement include improving contrast using dye-based chromoendoscopy (CE), using virtual CE that relies on filters or software manipulation, or using autofluorescence endoscopy based on filter technology with software manipulation.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ECE increased the detection of dysplasia during surveillance endoscopy as compared with standard-definition white light endoscopy (SDWLE) in a pooled analysis [Soetikno R et al. \u003Cem\u003EGastroenterology\u003C\/em\u003E. 2013]. High-definition white light endoscopy (HDWLE) improved detection rates for dysplasia about 2.5-fold when compared with SDWLE [Subramanian V et al. \u003Cem\u003EInflamm Bowel Dis\u003C\/em\u003E. 2013]. HDWLE detected dysplasia in 24 (11.5%) of 209 patients, whereas SDWLE detected dysplasia in 8 (5.0%) of 160 patients (prevalence ratio, 2.3; 95% CI, 1.03 to 5.11).\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EVenkat Subramanian, MD, St James University Hospital, Leeds, United Kingdom, presented the results of a randomized trial [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT02138318\u0026amp;atom=%2Fspmdc%2F15%2F14%2F15.atom\u0022\u003ENCT02138318\u003C\/a\u003E] to compare the rate of detection of dysplasia in patients with long-standing (\u0026gt;\u20058 years of disease) UC using HDWLE compared with high-definition chromoendoscopy (HDCE).\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAdults were included if they had long-standing extensive UC (extending proximal to splenic flexure) and a surveillance colonoscopy. Exclusion criteria were pregnancy, unwillingness or inability to give informed consent, or severe active colitis as assessed by the endoscopist at the time of the procedure.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EFor HDCE, 0.2% indigo carmine dye spray was used on withdrawal. Targeted and random biopsies from each colonic segment were taken from all patients. Patients randomly assigned to the HDWLE group (n\u2005=\u200553) were matched with those in the HDCE group (n\u2005=\u200550) for baseline demographics, including age, duration of disease, smoking status, presence of primary sclerosing cholangitis, family history of colorectal cancer, and use of 5-aminosalicylates or immunomodulators. About two-thirds of patients in the HDWLE group and about half the patients in the HDCE group were women. Results are shown in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E.\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\/16784\/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\/16784\/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\/16784\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 \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EDetection of Dysplasia With HDCE vs HDWLE\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-13\u0022\u003EThe increase in time for HDCE may be a result of the study\u2019s mandate to collect random biopsies. Since all of the dysplastic lesions detected arose from targeted biopsies rather than random biopsies, Dr Subramanian suggested that random biopsies could be omitted in practice.\u003C\/p\u003E\u003Cp id=\u0022p-14\u0022\u003EHDCE significantly improves the detection of dysplastic lesions in patients with long-standing extensive UC who are undergoing surveillance endoscopy. This method could become the procedure of choice for these patients and has been recommended in recent guidelines [Shergill AK et al. \u003Cem\u003EGastrointest Endosc\u003C\/em\u003E. 2015]. One limitation of the study was its single-center design in a small number of patients. To confirm these results, a study enrolling about 1600 participants across the United Kingdom is being initiated.\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\/15.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?nzlhj1\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?nzlhj1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}