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Nonpolypoid Colorectal Neoplasia in the United StatesThe Parachute Is Open
David Lieberman, MD
JAMA. 2008;299(9):1068-1069.
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People's minds are like parachutes—they only function when they are open.—Thomas Robert Dewar (1864-1930)
The history of modern medicine is riddled with stories of discovery, skepticism, rejection, and, sometimes, redemption and acceptance. For instance, the discovery of Helicobacter pylori by Marshall1 is a fairly recent example of initial rejection by the mainstream scientific community and ultimate redemption (as recognized by the Nobel Prize).
Similarly, reports from Japan in the 1980s and 1990s suggested that nonpolypoid (ie, flat or depressed) colorectal neoplasms (NP-CRNs) were common and ominous.2-3 Depressed lesions commonly harbored in situ or submucosal carcinoma. However, some western investigators were skeptical because such lesions were not commonly found in North American patient populations, and the rates of high-grade dysplasia in small flat polyps were low.4-5 In 1992, a prospective study from Nebraska found that although flat adenomas could be found with careful examination, none contained high-grade . . . [Full Text of this Article]
Author Affiliation: Division of Gastroenterology, Oregon Health & Science University, Portland VA Medical Center, Portland, Oregon.
RELATED ARTICLE
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
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Nonpolypoid Colorectal Neoplasm Detection with Colonoscopy
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