This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Related article  • Related letter  • Similar articles in JAMA  Topic Collections  • Oncology  • Colon Cancer  • Surgery  • Surgical Interventions  • Colorectal Surgery  • Diagnosis  • Gastroenterology  • Gastrointestinal Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In their cross-sectional study, Dr Soetikno and colleagues¹ reported that nonpolypoid colorectal neoplasms were relatively common in an older male veterans hospital population. We have several concerns regarding the study design and conclusions.

The terminology is unclear. A distinction must be made between the relatively flat lesions described in this study (defined as elevated lesions with a height less than half the diameter) and completely flat or depressed lesions. The authors note that "completely flat lesions are exceedingly rare" and were presumably absent in this study. Depressed lesions comprised less than 1% of all colorectal lesions (18/2770), only 4 of which were seen at screening. Therefore, nearly all nonpolypoid lesions were elevated from the surrounding mucosa, which is a critical distinction favoring detection at both standard colonoscopy and computed tomographic (CT) colonography.

Given the lack of metastatic potential, it is widely accepted that "carcinoma in situ" should . . . [Full Text of this Article]

Perry J. Pickhardt, MD
pj.pickhardt@hosp.wisc.edu
Department of Radiology
University of Wisconsin Medical School
Madison

Bernard Levin, MD
Department of Gastroenterology
University of Texas M. D. Anderson Cancer Center
Houston

John H. Bond, MD
Department of Gastroenterology
Minneapolis VA Medical Center
Minneapolis, Minnesota

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Prevalence of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Asymptomatic and Symptomatic Adults
, , , , , , , and
JAMA. ;299():1027-1035.
FULL TEXT  

RELATED LETTER

Screening for Nonpolypoid Colorectal Neoplasms--Reply
, , and
JAMA. ;299():2743-2744.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Colorectal Cancer Screening With CT Colonography: Key Concepts Regarding Polyp Prevalence, Size, Histology, Morphology, and Natural History
Pickhardt and Kim
Am. J. Roentgenol. 2009;193:40-46.
ABSTRACT | FULL TEXT  

Sensitivity of CT Colonography for Nonpolypoid Colorectal Lesions Interpreted by Human Readers and With Computer-Aided Detection
Park et al.
Am. J. Roentgenol. 2009;193:70-78.
ABSTRACT | FULL TEXT