Endoscopic Assessment of the Malignant Potential of the Nonpolypoid (Flat and Depressed) Colorectal Neoplasms: Thinking Fast, and Slow

Gastrointest Endosc Clin N Am. 2019 Oct;29(4):613-628. doi: 10.1016/j.giec.2019.06.006. Epub 2019 Jul 25.

Abstract

Current endoscopy training methodology does not meet the learning traits, skills, and needs of the newer generation of gastroenterologists. This article provides information on assessment of the malignant potential of colorectal neoplasms. It takes a modern approach on the topic and integrates relevant information that aligns with the thinking process. The theory of thinking fast (reflex) and slow (rational) is used. By doing so, it is hoped that the learning process can be expedited and practiced immediately. The focus is on preresection assessment of nonpolypoid colorectal neoplasms. Assessment of polypoid, sessile-serrated adenoma/polyp, or inflammatory bowel disease dysplasia is briefly discussed.

Keywords: Cololonoscopy; Colorectal cancer; Endoscopy; Endoscopy training; Optical diagnosis.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery
  • Clinical Competence*
  • Colonic Polyps / pathology
  • Colonoscopy / methods*
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / surgery*
  • Female
  • Gastroenterology / education
  • Humans
  • Intestinal Mucosa / pathology*
  • Male
  • Minimally Invasive Surgical Procedures / methods
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Patient Safety