BACKGROUND AND STUDY AIMS: The recognized pathway for @entity14 is the @entity2513 sequence. It is estimated that up to two-thirds of @entity14 arise from @entity6523 . In recent years, Japanese workers have suggested that early @entity14 may arise as "flat" or " @entity308 " rather than as polypoid lesions. Such flat or @entity308 and @entity420 have not been widely recognized in the West. A prospective study was carried out to search for flat and @entity308 in a British population, using Japanese colonoscopic techniques. @entity1 AND METHODS: In this prospective study at a British centre, 210 consecutive @entity1 attending for routine colonoscopy were examined for flat or @entity308 . The examinations were carried out using Japanese techniques by an experienced Japanese endoscopist (T.F.). RESULTS: Overall, 68 @entity652 were found, of which 40 (59%) were polypoid, 26 (38%) were flat, and two (3%) appeared @entity308 . The majority of the @entity652 contained areas of mild or moderate @entity1141 , but four were severely @entity6349 . Two of these were large polypoid tubulovillous @entity652 , the third was a 7-mm protruding polyp, and the fourth was a @entity308 @entity652 6 mm in diameter. Three @entity5 were also found. Of these, one was a 20-mm polyp, one a 15-mm flat elevation of the mucosa with a central @entity308 , and the third a 6-mm @entity308 . Finally, four Dukes' B or more advanced @entity420 were found. CONCLUSIONS: The polyp- @entity189 hypothesis prompts colonoscopists to search only for polypoid lesions when screening for @entity5 . A significant proportion of early @entity14 may therefore be missed. European colonoscopists require training in the recognition of flat elevated and @entity308 in order to detect @entity14 in their early stages.

Flat @entity652 in the United Kingdom: are treatable XXXX being missed?

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenomas', 'adenoma'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depressed adenomas', 'depressed', 'depression', 'depressed lesions', 'depression of the mucosa'] @entity5 :: ('MESH:D009369', 'Disease') :: ["Dukes' stage A adenocarcinomas", 'malignancy'] @entity189 :: ('MESH:D002277', 'Disease') :: ['carcinoma'] @entity6523 :: ('MESH:D018256', 'Disease') :: ['adenomatous polyps'] @entity14 :: ('MESH:D015179', 'Disease') :: ['colorectal neoplasms', 'colorectal malignancies', 'colorectal carcinomas'] @entity2513 :: ('MESH:C563365', 'Disease') :: ['adenoma-carcinoma'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinomas'] @entity6349 :: ('MESH:D004416', 'Disease') :: ['dysplastic'] @entity1141 :: ('MESH:C535662', 'Disease') :: ['dysplasia']
@entity5 :: (MESH:D009369,Disease) :: ['cancers']
