Cost Analysis of Endoscopic Mucosal Resection vs Surgery for Large Laterally Spreading Colorectal Lesions

Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer

“…Th e FITfecal DNA test had a 1-time sensitivity for CRC of 92%. Th e FIT assay tested in the study had 73.8% sensitivity for cancer, suggesting that most cancer sensitivity of the FIT-fecal DNA test can be achieved without addition of DNA markers. Advantages of the FIT-fecal DNA test include the highest single-time testing sensitivity for cancer of any noninvasive, nonimaging CRC screening test.…”

“…Cold resection techniques are eff ective and nearly devoid of clinically signifi cant bleeding risk and can be generally advised for nonpedunculated lesions <1 cm in size ( 72 ). Despite these risks, colonoscopy is the preferred approach to management of any benign colorectal polyp regardless of size or location because the alternative of surgical resection has higher mortality and cost compared with colonoscopy ( 73,74 ). To the extent that other screening tests eff ectively identify large lesions, they result in colonoscopy and do not prevent adverse events related to colonoscopic resection of large lesions.…”

Why attempt en bloc resection of non-pedunculated colorectal adenomas? A systematic review of the prevalence of superficial submucosal invasive cancer after endoscopic submucosal dissection

“…ESD represents an expensive alternative to the already reported convenience of EMR due to the longer time, expensive accessories and the need for hospitalisation in most cases 63. Thus, when considering the narrow trade-off between efficacy, on one side, and safety and burden, on the other, colorectal ESD should be cautiously implemented only in centres able to assure a low risk of adverse events and for lesions at high risk for SM1 invasion.…”

Prediction of Clinically Significant Bleeding Following Wide-Field Endoscopic Resection of Large Sessile and Laterally Spreading Colorectal Lesions: A Clinical Risk Score

“…Wide-fi eld endoscopic mucosal resection (WF-EMR) is established as the fi rst-line treatment for large sessile and laterally spreading colorectal lesions (LSL) owing to its effi cacy, safety and economic benefi ts over surgery (1)(2)(3). Clinically signifi cant post-WF-EMR bleeding (CSPEB) is the most frequent EMR-related adverse event.…”