Emmanuelle Williams, M.D.
Inflammatory bowel disease (IBD) is associated with a significantly higher risk of colorectal cancer than the general population. To improve early colorectal cancer detection, patients with a ten-year history of extensive colonic IBD are recommended to undergo colonoscopy surveillance at least every two years. Emmanuelle D. Williams, M.D., Penn State Milton S. Hershey Medical Center explains, “Currently recommended surveillance techniques (at least thirty-three random biopsies obtained from the entire extent of the colon) for IBD patients are time consuming and limited by a relatively low colorectal cancer detection rate where up to 25 percent of precancerous lesions are missed. Part of the challenge is the difficulty in visualizing pre-cancerous lesions in IBD patients because they can be multiple and flat with subtle irregularities rather than polypoid.” Chromoendoscopy, a technique that uses dye to highlight dysplastic tissue in existence since the 1970s, was introduced to IBD surveillance in 2003, and has since proven to markedly increase dysplastic lesion detection. While simple and inexpensive to do, Williams notes, “The technique requires training and practice, and additional time needed for obtaining dye-targeted biopsies and thus is typically only offered in tertiary care settings.”
