Subramanian V, Mannath J, Ragunath K et al. Aliment Pharmacol Ther 2011;33:304–12.
Subramanian et al. performed a meta-analysis to determine the diagnostic yield of chromoendoscopy versus conventional white-light endoscopy during screening colonoscopy for dysplasia and cancer. Chromoendoscopy yielded an increased dysplasia detection rate overall; however, the time taken to perform chromoendoscopy was significantly longer, with an average increase of 11 min per colonoscopy. Furthermore, cancer detection rates were no different with all cancers picked up by standard white-light endoscopy as well.
The amount of time invested by gastroenterologists (and pathologists) in detecting early dysplastic changes in patients with IBD using screening colonoscopy is immense. The focus in recent years has moved away from taking large numbers of random biopsies to more focused and targeted biopsies, to increase biopsy efficiency as well as dysplasia and cancer detection rates. Chromoendoscopy refers to any method of endoscopy that uses dyes or pigments to improve mucosal visualization. It has become increasingly promoted for dysplasia detection although is not yet a universally accepted part of routine clinical practice.