Prevalence of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Asymptomatic and Symptomatic Adults

Soetikno, Roy; Kaltenbach, Tonya; Rouse, Robert V.; Park, Walter G.; Maheshwari, Anamika; Sato, Tohru; Matsui, Shigeru; Friedland, Shai

doi:10.1001/jama.299.9.1027

Cited by 555 publications

(393 citation statements)

References 34 publications

(49 reference statements)

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“…Although the existence of these lesions had been reported earlier, their appreciable prevalence and potential significance in diagnosis and management of CRC attracted attention in the western literature during the development of the EU guidelines [58,59]. …”

Section: Discussionmentioning

confidence: 99%

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

Karsa¹,

Patnick²,

Segnan³

et al. 2012

Endoscopy

249

187

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Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010.They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines. IntroductionAccording to recent estimates by the International Agency for Research on Cancer [1], colorectal cancer (CRC) is the most common cancer in Europe with 432 000 new cases reported annually in men and women combined. It is the second most common cause of cancer deaths in Europe with 212 000 deaths reported in 2008.Worldwide, CRC ranks third in incidence and fourth in mortality with an estimated 1.2 million cases and 0.6 million deaths annually. In the 27 Member States of the European Union (EU), CRC ranks first in incidence and second in mortality, with approximately 334000 new cases and 149000 deaths estimated in 2008.Even in those Member States in the lower range for age-standardized rates of CRC, the burden of disease is significantly greater when compared with many other HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript regions of the world (see reference [1]). CRC is therefore an important health problem across the EU.Screening can be effective in cancer control in populations with a significant burden of CRC, provided the services are of high quality [2]. The aim of CRC screening is to lower the burden of cancer in the population by discovering disease in its early, latent stages [3]. Evidence-based methods permit treatment that is more effective than if disease is diagnosed later when symptoms have occurred. Early treatment of invasive lesions, for example by endoscopic resection of early CRC, can also be less detrimental for quality of life. The endoscopic removal of pre-malignant lesions also reduces the incidence of CRC by avoiding the progression to cancer. Randomized trials in people of average risk invite...

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Section: Discussionmentioning

confidence: 99%

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

Karsa¹,

Patnick²,

Segnan³

et al. 2012

Endoscopy

249

187

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“…These lesions, however, can protrude (or be recessed) significantly relative to the surrounding mucosa. 1,2 Conventional colonoscopy relying primarily on coloration is estimated to miss one out of every four lesions. 3,4 A method to provide endoscopic measurement of surface topography paired with conventional color imagery could reduce this high missed lesion rate.…”

Section: Introductionmentioning

confidence: 99%

Photometric stereo endoscopy

et al. 2013

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Abstract. While color video endoscopy has enabled wide-field examination of the gastrointestinal tract, it often misses or incorrectly classifies lesions. Many of these missed lesions exhibit characteristic three-dimensional surface topographies. An endoscopic system that adds topographical measurements to conventional color imagery could therefore increase lesion detection and improve classification accuracy. We introduce photometric stereo endoscopy (PSE), a technique which allows high spatial frequency components of surface topography to be acquired simultaneously with conventional two-dimensional color imagery. We implement this technique in an endoscopic form factor and demonstrate that it can acquire the topography of small features with complex geometries and heterogeneous optical properties. PSE imaging of ex vivo human gastrointestinal tissue shows that surface topography measurements enable differentiation of abnormal shapes from surrounding normal tissue. Together, these results confirm that the topographical measurements can be obtained with relatively simple hardware in an endoscopic form factor, and suggest the potential of PSE to improve lesion detection and classification in gastrointestinal imaging. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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“…However, white-light endoscopy alone is an imperfect technology that only offers structural details based on visual observation and can result in miss rates of up to 25% (16). It was also reported that flat lesions in the colon, which are more difficult to detect with white-light endoscopy, were fivefold more likely to contain cancerous tissue than the visually apparent polyps detected by conventional colonoscopy (17). This problem of failed detection could be significantly minimized with the addition of a molecular imaging component that reveals important functional information in conjunction with the structural component that white light endoscopes offer today.…”

mentioning

confidence: 99%

A Raman-based endoscopic strategy for multiplexed molecular imaging

Zavaleta

Garai

Liu

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

200

204

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Endoscopic imaging is an invaluable diagnostic tool allowing minimally invasive access to tissues deep within the body. It has played a key role in screening colon cancer and is credited with preventing deaths through the detection and removal of precancerous polyps. However, conventional white-light endoscopy offers physicians structural information without the biochemical information that would be advantageous for early detection and is essential for molecular typing. To address this unmet need, we have developed a unique accessory, noncontact, fiber optic-based Raman spectroscopy device that has the potential to provide real-time, multiplexed functional information during routine endoscopy. This device is ideally suited for detection of functionalized surface-enhanced Raman scattering (SERS) nanoparticles as molecular imaging contrast agents. This device was designed for insertion through a clinical endoscope and has the potential to detect and quantify the presence of a multiplexed panel of tumor-targeting SERS nanoparticles. Characterization of the Raman instrument was performed with SERS particles on excised human tissue samples, and it has shown unsurpassed sensitivity and multiplexing capabilities, detecting 326-fM concentrations of SERS nanoparticles and unmixing 10 variations of colocalized SERS nanoparticles. Another unique feature of our noncontact Raman endoscope is that it has been designed for efficient use over a wide range of working distances from 1 to 10 mm. This is necessary to accommodate for imperfect centering during endoscopy and the nonuniform surface topology of human tissue. Using this endoscope as a key part of a multiplexed detection approach could allow endoscopists to distinguish between normal and precancerous tissues rapidly and to identify flat lesions that are otherwise missed.optical | colonoscopy E arly detection is the most effective means of improving prognosis for many patients who have cancer; consequently, the development of new point-of-care diagnostic strategies with sufficient sensitivity and specificity for early cancer detection is critical for effective disease management. Raman spectroscopy has emerged as an excellent analytical tool for multiparameter molecular analyses with both high sensitivity and multiplexing capabilities. These unique features offer the potential for early diagnosis, which could have a significant impact on the survival rates of patients with cancer.Raman spectroscopy is based on an inelastic light-scattering phenomenon that provides detailed chemical information, but biomedical applications have been limited by very low signalto-noise ratios. Most photons are elastically scattered when they interact with matter, where the scattered photons maintain the same energy and wavelength as the incident photons. However, a very small fraction of light is inelastically scattered, meaning that the linearly inelastic scattered photons usually lose energy, resulting in a longer wavelength. This inelastic scattering of light was first observed in 1928 by...

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Prevalence of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Asymptomatic and Symptomatic Adults

Cited by 555 publications

References 34 publications

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

Photometric stereo endoscopy

A Raman-based endoscopic strategy for multiplexed molecular imaging

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