New-generation chromoendoscopy may increase confidence in the DISCARD2 study

We read with interest the article by Rees et al, which assessed narrow band imaging (NBI) optical diagnosis of small colorectal polyps in routine clinical practice (the DISCARD2 study).1 Several modalities can potentially be used for screening colonoscopy. The quality of white light endoscopy (WL) has greatly improved after the advent of high-definition endoscopy. Chromoendoscopy (CE) with indigo carmine is one of the traditional dye spraying methods for clearer visualisation of subtle lesions. Image-enhanced endoscopy is also becoming popular, and the new NBI system has improved brightness and contrast relative to those of the first-generation systems.

The study by Rees et al did not show the usefulness of NBI in a multicentre routine (non-specialist) clinical practice for differentiating adenoma from non-adenomatous lesions and concluded that routine use of NBI was not recommended outside of specialist centres. This is an important message because many randomised control trials are conducted in...

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