Non-Polyp Colon Lesions Hard to Detect

These flat growths are relatively common and tend to be cancerous, study finds

By Serena Gordon
HealthDay Reporter

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TUESDAY, March 4 (HealthDay News) -- While the majority of colon cancers were thought to develop from polyps, a new study challenges that assumption and points out that so-called non-polypoid (flat or depressed) lesions in the colon are also likely to turn into cancer.

A study in the March 5 issue of the Journal of the American Medical Association reports that such lesions were present in almost 10 percent of people screened for the study, and that these lesions were 10 times more likely to be cancerous than polyps were.

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"Colorectal cancer is common, it is preventable, and it can be prevented even better," said the study's lead author, Dr. Roy Soetikno, chief of gastroenterology at the Veterans Affairs Palo Alto Health Care System in California. "Not all colon cancers are created equal, and doctors will now start looking for those that aren't so obvious."

Soetikno said it's like when you cross the street: You look left, and you look right before you cross, but "you never look carefully for the pothole on the street. This study is saying that doctors need to look at everything, including the potholes, to do a much better job."

The good news is that with current colonoscopy technology, doctors can find and remove these lesions. The bad news is that virtual colonoscopy (CT colonography) is not yet sensitive enough to pick up these dangerous lesions.

Previously, experts believed that these non-polypoid lesions were mainly found in people of Japanese descent, and U.S. doctors weren't specially trained to look for them. Soetikno and his colleagues underwent special training with specialists from Japanese endoscopy centers to learn to better detect these potentially pre-cancerous lesions.

Using their new knowledge, the U.S. researchers searched for non-polypoid lesions among 1,819 veterans who were already scheduled to undergo standard colonoscopy. The average age of the study participants was 64, and 95 percent were male. And, most -- 79 percent -- were white.

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