N Suzuki1, I C Talbot, B P Saunders. 1. Wolfson Unit for Endoscopy Academic Department of Histopathology, St Mark's Hospital, Harrow, UK.
Abstract
OBJECTIVE: Small, flat colorectal cancers have been widely reported in the Japanese literature but are thought to occur rarely outside Japan. The aim of this retrospective cohort study was to clarify the prevalence of flat colorectal cancer in a Western population. METHODS: One thousand and twenty-six consecutive colonoscopies performed by a single experienced endoscopist were retrospectively analysed over a two-year period. The morphology, site and histological appearance of all documented colorectal cancers (CRC) were recorded. RESULTS: Forty-seven cases of CRC were detected, five of which (10%) demonstrated flat configuration. Flat cancers varied between 8 and 15 mm in diameter (mean 11 mm). Histologically, all flat lesions were moderately differentiated Dukes A adenocarcinomas. Two of these cancers contained no adenomatous component. CONCLUSION: This study confirms that small, flat colorectal cancers are not an uncommon finding at colonoscopy in Western patients. Compared to polypoid neoplastic lesions, flat cancers appear to undergo malignant change at a smaller size.
OBJECTIVE: Small, flat colorectal cancers have been widely reported in the Japanese literature but are thought to occur rarely outside Japan. The aim of this retrospective cohort study was to clarify the prevalence of flat colorectal cancer in a Western population. METHODS: One thousand and twenty-six consecutive colonoscopies performed by a single experienced endoscopist were retrospectively analysed over a two-year period. The morphology, site and histological appearance of all documented colorectal cancers (CRC) were recorded. RESULTS: Forty-seven cases of CRC were detected, five of which (10%) demonstrated flat configuration. Flat cancers varied between 8 and 15 mm in diameter (mean 11 mm). Histologically, all flat lesions were moderately differentiated Dukes A adenocarcinomas. Two of these cancers contained no adenomatous component. CONCLUSION: This study confirms that small, flat colorectal cancers are not an uncommon finding at colonoscopy in Western patients. Compared to polypoid neoplastic lesions, flat cancers appear to undergo malignant change at a smaller size.
Authors: Jeff L Fidler; Zheng Zhang; Benjamin A Herman; Paul J Limburg; J G Fletcher; Abraham Dachman; Jay P Heiken; Mark D Kuo; Christine O Menias; Bettina Siewert; Jugesh I Cheema; Richard G Obregon; Peter Zimmerman; Karen M Horton; Kevin Coakley; Revathy B Iyer; Amy Hara; Robert A Halvorsen; Giovanna Casola; Judy Yee; Lawrence J Burgart; C Daniel Johnson Journal: AJR Am J Roentgenol Date: 2014-12 Impact factor: 3.959
Authors: Tanja E Argillander; Jan J Koornstra; Mariette van Kouwen; Alexandra Mj Langers; Fokko M Nagengast; Juda Vecht; Wouter H de Vos Tot Nederveen Cappel; Evelien Dekker; Peter van Duijvendijk; Hans Fa Vasen Journal: United European Gastroenterol J Date: 2018-06-11 Impact factor: 4.623