Screening for colorectal cancer in patients with inflammatory bowel disease. Should we already perform chromoendoscopy in all our patients?

Table 1 Disadvantages of chromoendoscopy (Adapted from Marion J and Sands B[17])

Operator barriers:

Training of fellows, gastroenterologists, nurses, and staff

Unknown learning curve

Identifying clinically relevant lesions

Operational barriers:

Availability of dye, equipment

Billing and reimbursement

Time requirement

Prep quality

Confounding of findings by inflammation

Knowledge barriers:

Uncertain natural history of dysplasia detected by CE

Uncertain implications of prior surveillance findings for management