Comparative efficacy and safety of endoscopic modalities for colorectal cancer screening in inflammatory bowel disease: a systematic review and network meta-analysis

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dc.contributor.authorSinopoulou, Vasilikien
dc.contributor.authorNigam, Gaurav B.en
dc.contributor.authorGordon, Morrisen
dc.contributor.authorGaneshan, Meghanaen
dc.contributor.authorTokonyai, Mitchell Rudoen
dc.contributor.authorDolwani, Sunilen
dc.contributor.authorIacucci, Mariettaen
dc.contributor.authorRutter, Matten
dc.contributor.authorSubramanian, Venkaten
dc.contributor.authorWilson, Anaen
dc.contributor.authorEast, James E.en
dc.contributor.funderNational Institute for Health Researchen
dc.contributor.funderNational Institute for Health and Care Researchen
dc.date.accessioned2025-05-13T08:54:18Z
dc.date.available2025-05-13T08:54:18Z
dc.date.issued2025en
dc.description.abstractBackground & Aims: Long-standing inflammatory bowel disease (IBD) increases the risk of colonic neoplasia, necessitating effective screening strategies. This network meta-analysis compared the efficacy and safety between different endoscopic modalities in the high-definition (HD) era. Methods: We searched CENTRAL, ClinicalTrials.gov, Embase, MEDLINE, and WHO for randomized controlled trials (RCTs) comparing endoscopic modalities for screening colonoscopy in patients with IBD up to February 2024. The primary outcome was detection of any dysplastic lesion per patient. The certainty of the evidence was GRADE-assessed. Results: A total of 26 RCTs involving 4159 participants were included, comparing 6 endoscopic modalities: HD white light endoscopy (HD-WLE), HD virtual chromoendoscopy (HD-VCE), HD dye-based chromoendoscopy (HD-DCE), HD-WLE with segmental re-inspection (SR), auto-fluorescence imaging (AFI), and full-spectrum endoscopy (FUSE). HD-DCE may have a small benefit in detecting dysplasia over HD-WLE (low certainty, small magnitude;: relative risk [RR], 1.42; 95% confidence interval [CI], 1.02–1.98). FUSE may be no different to HD-WLE (low certainty: RR, 3.24; 95% CI, 0.66–15.87). The other modalities were assessed as very low certainty (HD-WLE with SR: RR, 1.35; 95% CI, 0.66–2.77; AFI: RR, 1.18; 95% CI, 0.55–2.57; HD-VCE: RR, 0.99; 95% CI, 0.69–1.43). Sensitivity analyses supported these findings. Limited data on serious adverse events precluded meta-analysis; 2 serious events were reported among 2164 patients (very low certainty). Conclusions: HD-DCE is the only modality for IBD surveillance with evidence (low-certainty) demonstrating potential to detect more dysplastic lesions compared with HD-WLE. There was no evidence to support any of the other modalities as an alternative due to very low-certainty evidence.en
dc.description.sponsorshipNational Institute for Health and Care Research (Grant number 302607)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationSinopoulou, V., Nigam, G. B., Gordon, M., Ganeshan, M., Tokonyai, M. R., Dolwani, S., Iacucci, M., Rutter, M., Subramanian, V., Wilson, A. and Al Bakir, I. (2024) 'Comparative efficacy and safety of endoscopic modalities for colorectal cancer screening in inflammatory bowel disease: A systematic review and network meta-analysis', Clinical Gastroenterology and Hepatology. https://doi.org/10.1016/j.cgh.2024.11.008en
dc.identifier.doi10.1016/j.cgh.2024.11.008en
dc.identifier.issn15423565en
dc.identifier.journaltitleClinical Gastroenterology and Hepatologyen
dc.identifier.urihttps://hdl.handle.net/10468/17433
dc.language.isoenen
dc.publisherW.B. Saundersen
dc.rights© 2025, the Author(s). Published by Elsevier Inc. on behalf of the AGA Institute. This is an open access article under the CC BY license. https://creativecommons.org/licenses/by/4.0/en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectChromoendoscopyen
dc.subjectColorectal cancer screeningen
dc.subjectDye-based chromoendoscopy (DCE)en
dc.subjectDysplasiaen
dc.subjectEndoscopic surveillanceen
dc.subjectHigh-definition endoscopyen
dc.subjectInflammatory bowel disease (IBD)en
dc.subjectNetwork meta-analysisen
dc.subjectVirtual chromoendoscopy (VCE)en
dc.subjectWhite light endoscopy (WLE)en
dc.subject~Medicine - Journal Articles~en
dc.titleComparative efficacy and safety of endoscopic modalities for colorectal cancer screening in inflammatory bowel disease: a systematic review and network meta-analysisen
dc.typeArticle (peer reviewed)en
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