Evolving endoscopic strategies for detection and treatment of neoplastic lesions in inflammatory bowel disease.

The paradigm for neoplasia surveillance in IBD is rapidly evolving with advancements in endoscopic imaging technology. Modern technology has demonstrated a remarkably improved capacity to detect and characterize subtle neoplastic lesions. As such, practices of obtaining interval random biopsy specimens to identify “invisible”neoplasia and of recommending total proctocolectomy for treatment of early neoplastic lesions are gradually being phased out. Further research is required to confirm the safety and effectiveness of endoscopic resection of more advanced neoplastic lesions, including DALMs and lesions bearing HG-IEN. Moving forward, studies evaluating CRC risk profiles in IBD patients would be useful to develop rational and cost-effective individualized strategies for neoplasia surveillance and management. Overall, as we progress toward more sophisticated approaches to cancer prevention, the outlook for IBD patients grows ever better.