Is chromoendoscopy the new standard for cancer surveillance in patients with ulcerative colitis?

Chromoendoscopy was introduced in 2003 as a novel 'red flag' technique that aimed to increase the sensitivity of identifying flat, neoplastic lesions in patients with ulcerative colitis. The improved sensitivity of chromoendoscopy over standard white-light endoscopy has been confirmed in European and Asian centers. This commentary discusses the findings from a prospective, controlled study from the Mount Sinai Hospital in New York. The findings of this study provide unequivocal evidence that chromoendoscopy is superior to white-light endoscopy in the detection of neoplasias in patients with IBD. The authors of this study identified a greater number of lesions and a higher number of patients with dysplasia by use of this method and targeted biopsy sampling compared with standard endoscopy with random biopsy sampling. Chromoendoscopy in combination with targeted biopsies, therefore, has emerged as the new standard of cancer surveillance in patients with ulcerative colitis, and we can expect this technique to be incorporated into clinical guidelines shortly.