Magnification endoscopy may be able to identify high-risk dysplastic lesions several years before they grow into visible polyps. The technique, which can magnify the lining of the colon 70 times, uses a combination of optical and digital magnification with a Fujinon endoscope. It is currently available at few than a dozen institutions internationally.

Unlike standard colon cancer screens that rely on the detection and removal of polyps -- only 5 percent of which ever become cancerous -- magnification endoscopy allows physicians to see microscopic dysplastic lesions called aberrant crypt foci.

"We believe magnification endoscopy can become the gold standard for determining a patient's lifetime risk of developing colon cancer," said Richard Benya, MD. "If we can identify patients who are not at risk for colon cancer, we can potentially save patients from additional testing and removal of polyps. The current standard of care for identifying, removing and testing polyps in everyone over 50 years old has an enormous impact on the cost of public health."

Dysplastic crypt foci have proven to be a relevant marker for colon cancer in animal models. Although the lesions themselves do not cause cancer, they are believed to be important in determining areas of the colon at higher risk for development of cancer.

Robert Carroll, MD, another investigator, noted that early risk assessment may enable physicians to provide patients with prevention strategies. "We see no reason why patients cannot make positive changes in their life to prevent disease before it occurs." He said that offering patients a complete nutritional and health evaluation along with magnification endoscopy gives them the ability "to change the number of aberrant crypt foci in the colon over time, and thereby lessen the likelihood of developing cancer."

Magnification endoscopy as refined at the University begins with washing and staining of the colon’s lining with use of a barium enema infused with methylene blue dye. Doctors then examine the rectum and colon using a standard colonoscope. Afterward, the magnification lens is turned on to allow a more detailed look at the distal colon, where the majority of cancers occur. Physicians create a digital movie of each procedure for later analysis.