INTESTINE Vol.8 No.1(5-2)

Theme Prevalence of the IIc type colorectal neoplasm
Title Flat and depressed colorectal neoplasms in the United States of America
Publish Date 2004/01
Author Lyn Sue Kahng Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine
Author Shai Friedland Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine
Author Suzanne Matsui Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine
Author Magdalena Kaczynska Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine
Author Roy Soetikno Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine
[ Summary ] Flat and depressed (F and D) colorectal neoplasms have been described with increasing frequency in Western populations, yet awareness of these lesions is not widespread in the United States. There is still controversy over their clinical significance in our patients, as their biology may differ between Asian and Western populations. Also, endoscopists face several logistical obstacles in the detection of F and D lesions such as time constraints, poor bowel preparation, and lack of training in specialized techniques such as chromoendoscopy and endoscopic mucosal resection (EMR). The most recent U.S. guidelines on colonoscopy and colorectal cancer screening, published in 2002 and 2003, have noted the discovery of F and D lesions in the West. Thus, while the debate over their existence in Western populations is over, their significance and the changes in colonoscopy technique necessary to detect and treat them have only begun to be addressed.
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