Nonpolypoid Colorectal Neoplasm Detection with Colonoscopy

In U.S. patients, nonpolypoid lesions are more common and more likely to be malignant than we previously thought.

Most screening for colorectal cancer focuses on polypoid lesions; nonpolypoid (especially flat or depressed) colorectal neoplasms (NP-CRNs) have been considered to be relatively uncommon, unlikely to be malignant, and specific to certain subpopulations (such as people of Japanese descent). This cross-sectional study of 1819 patients (mean age, 64) at a California veterans’ hospital suggests otherwise.

All patients underwent elective colonoscopy for screening (34%), surveillance (36%), or symptom-based (30%) indications. Some type of superficial neoplasm was detected in 764 patients (42%). NP-CRNs were found in 170 patients (9%); 89 of them had only NP-CRNs, and 81 had both nonpolypoid and polypoid lesions. Of 227 flat or depressed NP-CRNs, 1…

Reviewing Author

Thomas L. Schwenk, MD

Disclosures

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Thomas L. Schwenk, MD

Disclosures

Editorial BoardsUpToDate