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