Role of magnifying colonoscopy for diagnosis of colorectal neoplasms: From the perspective of Japanese colonoscopists.

Colorectal cancer is the third leading cause of cancer-related death. As the therapeutic strategy for colorectal cancer depends on the clinical stage of the tumor, precise and accurate staging is necessary prior to treatment decision-making. Colonoscopy is an essential tool for detection and prevention of colorectal cancer, as it also allows for removal of adenomatous lesions. Using conventional endoscopy, however, it is sometimes difficult to differentiate neoplastic lesions from non-neoplastic lesions. Several new endoscopic technologies have been developed to provide a more precise diagnosis. Magnifying chromoendoscopy and narrow-band imaging endoscopy with or without magnification are invaluable not only for distinction of colorectal neoplastic lesions from non-neoplastic lesions, but also for the accurate diagnosis of invasion depth in colorectal cancers. Based on an accumulation of a large number of clinical data, the use of magnifying colonoscopy has become inevitable for the prediction of histology and the diagnosis of invasion depth of colorectal neoplasms in Japan.