This study confirms that flat adenomas and carcinomas occur in the West and demonstrates the malignant potential of such lesions, which can be managed successfully using endoscopic techniques. Endoscopic mucosal resection with high-magnification chromoscopy is a safe and effective form of treatment for sessile or flat colorectal lesions. Complete resection can improve the accuracy of histopathological diagnosis. However, colonoscopists require training in these procedures in order to improve the rate of colorectal cancer detection.

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FC performs modestly as a screening test to exclude small bowel inflammation. However, we recommend interpretation within the overall clinical context to avoid overlooking the infrequent patient with small bowel inflammation and a negative FC.

There was a low diagnostic yield in patients referred with suspected CD although a diagnosis at SBCE was predictive of a clinical diagnosis in the majority after a mean follow-up of 15 months. A diagnosis of CD was more likely in the IBDU and established CD cohort. SBCE diagnoses changed management in the majority of patients.