IBD Neoplasia Surveillance RCT

Inclusion Criteria: Each potential participant must satisfy all of the following criteria to be enrolled in the study. ≥ 18 years old Historical endoscopic/histologic disease extending beyond the rectum in UC or involving ≥ 1/3 of colorectum in CD> 50% of colon present, with remaining colon meeting above minimum criteria for disease extent (beyond rectum in UC, ≥1/3 colorectum in CD) cIBD ≥ 8 years duration (or at any time after diagnosis if a patient also has primary sclerosing cholangitis) In symptomatic remission at time of colonoscopy For CD: Harvey-Bradshaw Index < 541 For UC or IBDU: Partial Mayo Score ≤ 242 Major purpose of colonoscopy is neoplasia screening/surveillance Undergoing colonoscopy with high-definition white light endoscopy Exclusion Criteria: Persons who are unable to provide informed consent Persons with a history of colorectal cancer Persons with prior subtotal or total colectomy (>50% of colon removed) Persons undergoing repeat colonoscopy to follow-up on recently diagnosed neoplasia identified within the past year Persons undergoing pancolonic chromoendoscopy or pancolonic virtual chromoendoscopy Colon mucosa visibility deemed inadequate for surveillance after washing/suctioning (Boston Bowel Preparation Score of 0 or 1 in any segment) Incomplete colonoscopy (unable to reach cecum or terminal ileum [if no cecum]) Moderate-to-severe inflammation (Mayo 2-3) involving ≥ 25% of colorectum or mild inflammation (Mayo 1) involving ≥ 50% of colorectum