Dysplasia detection is similar between chromoendoscopy and high-definition white-light colonoscopy in inflammatory bowel
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ORIGINAL ARTICLE
Dysplasia detection is similar between chromoendoscopy and high-definition white-light colonoscopy in inflammatory bowel disease patients: a US-matched case-control study Kofi Clarke 1 & Mitchell Kang 1 & Venkata Subhash Gorrepati 1 & Jonathan G. Stine 1,2 & Andrew Tinsley 1 & Emmanuelle Williams 1 & Matthew Moyer 1 & Matthew Coates 1 Accepted: 14 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction Inflammatory bowel disease (IBD) patients are at greater risk of developing colorectal cancer (CRC). Detection of precursor dysplasia is important for cancer prevention. Recent guidelines recommend dye chromoendoscopy (DCE) as the preferred method for dysplasia detection. Universal adoption of DCE is time-consuming and may limit endoscopy access. The benefit of universal application of the guidelines is unclear. We compared high-definition white-light colonoscopy (HD-WLC) with DCE for dysplasia detection in IBD patients. Methods We conducted a retrospective case-control study of adult IBD patients undergoing dysplasia surveillance between September 1, 2015, and February 1, 2020. DCE cases were matched to HD-WLC in a 1:1 ratio for gender, IBD diagnosis, and age. DCE patients were considered high risk for colorectal cancer by the referring provider. Results A total of 187 subjects were enrolled. Majority were males, were Caucasian, and had longstanding IBD (primarily ulcerative colitis). Baseline characteristics were similar between the two groups, except for history of surgery, duration of IBD, and history of dysplasia. There was no significant difference in dysplasia detection between DCE and HD-WLC (10.2% vs 6.7%, p = 0.39). More polyps were detected in the DCE arm compared with the HD-WLC group (1.35 vs 0.80, p = 0.018), but adenoma detection rate was not statistically different between the two groups (10.2% vs 9.0%, p = 0.31). Mean withdrawal time was longer in the DCE group (24.6 min vs 15.4, p < 0.001). Conclusions There were no differences in dysplasia detection using DCE compared with HD-WLC, although withdrawal times were longer with DCE. Keywords Colorectal cancer . Dye chromoendoscopy . Inflammatory bowel disease
Study highlights 1) What is current knowledge ✓ Accurate detection of dysplasia is crucial for early colorectal cancer detection in patients with inflammatory bowel disease. ✓ Guidelines have suggested dye chromoendoscopy as the preferred method for dysplasia detection; however, its benefit in a real-world setting with challenges in implementation remains unknown. 2) What is new here ✓ Our study shows that there is no difference in dysplasia detection between chromoendoscopy and high-definition white-light colonoscopy. ✓ These findings support the growing evidence that implementing universal chromoendoscopy for dysplasia surveillance is costlier and time-consuming with little benefit in everyday IBD clinical care. * Kofi Clarke [email protected] Extended author information available on the last page of the article
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