• Colorectal cancer
• surveillance
• colitis
• healthcare costs
• colonoscopy
• dye spray, colonic neoplasms
• colorectal cancer screening
• health economics
• IBD clinical

The new 2010 British Society of Gastroenterology (BSG) recommendations for colitis surveillance reported in Gut represent a paradigm shift in attempts to detect dysplasia in colitis compared with the 2002 guidelines.1 2 Specifically, the strong recommendation for chromoendoscopy ‘dye spray’ to improve detection rather than large numbers of random biopsies is a major shift in colonoscopic practice, backed by increasingly compelling clinical trial evidence.3 4 Surveillance intervals are also newly defined by risk rather than disease duration. In the current economic environment, new techniques and strategies need to show that they are cost-effective for widespread implementation to occur. The authors provide a basic cost–benefit analysis based on the numbers of colonoscopies performed under old and new guidelines but do not consider other costs—specifically, histology and endoscopic equipment costs. Also, it is not clear how they arrived at the numbers in each risk group.

We recently performed an audit of all patients undergoing …