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Techniques for targeting screening in ulcerative colitis

¹ Department of Endoscopy, Royal Hallamshire Hospital, Sheffield, UK
² Department of Colorectal Surgery, Sheffield NHS Foundation Trust, Sheffield, UK

Correspondence to:
Correspondence to:
Dr David Paul Hurlstone
17 Alexandra Gardens, Lyndhurst Road, Nether Edge, Sheffield S11 9DQ, UK; p.hurlstone{at}shef.ac.uk

Patients with longstanding chronic ulcerative colitis are "at risk" of developing colorectal cancer. Approximately 1 in 6 patients will die as a result of colorectal malignancy, which can often be difficult to detect using conventional "white light" colonoscopy. New endoscopic techniques and technologies including the use of dye sprays, "chromoendoscopy", high magnification chromoscopic colonoscopy and recently chromoscopic assisted confocal laser scanning in vivo endomicroscopy have now been introduced to improve the diagnostic yield of intraepithelial neoplasia at screening colonoscopy. This review details the true "risk" of colorectal cancer complicating ulcerative colitis, discusses the objective evidence to support current endoscopic screening guidelines, and describes the imminent technological paradigm shift about to occur in the endoscopic management and detection of intraepithelial neoplasia.

Abbreviations: ALM, adenoma-like mass; CLE, confocal laser endomicroscope; CRC, colorectal cancer; CUC, chronic ulcerative colitis; DALM, dysplasia-associated lesion or mass; FAP, familial adenomatous polyposis; GI, gastrointestinal; HGD, high grade dysplasia; HMCC, high magnification chromoscopic colonoscopy, LGD, low grade dysplasia; IBD, inflammatory bowel disease; IC, indigo carmine; IN, intraepithelial neoplasia; MB, methylene blue; PSC, primary sclerosing cholangitis; UV, ultraviolet