This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Related articles  • Related letters  • Similar articles in JAMA  Topic Collections  • Oncology  • Colon Cancer  • Patient-Physician Relationship/ Care  • Treatment Adherence  • Radiologic Imaging  • Surgery  • Surgical Interventions  • Colorectal Surgery  • Diagnosis  • Computed Tomography  • Drug Therapy  • Adherence  • 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 multicenter cross-sectional study of the diagnostic accuracy of computed tomographic (CT) colonography for the detection of advanced neoplasia in individuals at increased risk of colorectal carcinoma, Dr Regge and colleagues¹ did not provide the frequency of adenomas that were nonpolypoid flat (ie, with a height of less than half of the lesion diameter) and depressed (ie, with a base that is lower than the normal mucosa) detected at colonoscopy. Such lesions are recognized with increasing frequency by skilled endoscopists in the United States,^2-3 may compose up to about 17% of precancerous adenomas,⁴ and are often missed by CT colonography (with as many as 66% of flat lesions of 5-9 mm and 40% of flat lesions 10 mm missed⁴).

Moreover, the prevalence of flat lesions has been shown to be 2.6 times higher in a high-risk population (with personal or family history of colorectal neoplasm) . . . [Full Text of this Article]

Claude Matuchansky, MD
claude.matuchansky@wanadoo.fr
Lariboisiere-Saint Louis Faculty of Medicine
Paris 7-Denis Diderot University
Paris, France

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

RELATED ARTICLES

Diagnostic Accuracy of Computed Tomographic Colonography for the Detection of Advanced Neoplasia in Individuals at Increased Risk of Colorectal Cancer
Daniele Regge, Cristiana Laudi, Giovanni Galatola, Patrizia Della Monica, Luigina Bonelli, Giuseppe Angelelli, Roberto Asnaghi, Brunella Barbaro, Carlo Bartolozzi, Didier Bielen, Luca Boni, Claudia Borghi, Paolo Bruzzi, Maria Carla Cassinis, Massimo Galia, Teresa Maria Gallo, Andrea Grasso, Cesare Hassan, Andrea Laghi, Maria Cristina Martina, Emanuele Neri, Carlo Senore, Giovanni Simonetti, Silvia Venturini, and Giovanni Gandini
JAMA. 2009;301(23):2453-2461.
ABSTRACT | FULL TEXT  

Computed Tomographic Colonography for Patients at High Risk of Colorectal Cancer: Trading Accuracy for Access and Compliance
Emily Finlayson
JAMA. 2009;301(23):2498-2499.
EXTRACT | FULL TEXT  

Prevalence of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Asymptomatic and Symptomatic Adults
Roy M. Soetikno, Tonya Kaltenbach, Robert V. Rouse, Walter Park, Anamika Maheshwari, Tohru Sato, Suzanne Matsui, and Shai Friedland
JAMA. 2008;299(9):1027-1035.
ABSTRACT | FULL TEXT  

Nonpolypoid Colorectal Neoplasia in the United States: The Parachute Is Open
David Lieberman
JAMA. 2008;299(9):1068-1069.
EXTRACT | FULL TEXT  

RELATED LETTERS

Computed Tomographic Colonography for Detecting Advanced Neoplasia
Paul Pisarik
JAMA. 2009;302(14):1527-1528.
EXTRACT | FULL TEXT  

Computed Tomographic Colonography for Detecting Advanced Neoplasia—Reply
Giovanni Galatola, Cristiana Laudi, and Daniele Regge
JAMA. 2009;302(14):1528.
EXTRACT | FULL TEXT  

Computed Tomographic Colonography for Detecting Advanced Neoplasia—Reply
Emily Finlayson
JAMA. 2009;302(14):1528-1529.
EXTRACT | FULL TEXT