Diagnostic findings in endoscopic screening of superficial colorectal neoplasia: results from a prospective study

BACKGROUND: A prospective study was carried out to clarify the efficacy ofan endoscopic screening program for detecting superficial colorectalneoplasias by color changes such as faint redness or discoloration, whichhave been described as a key finding of these lesions in the literature.METHODS: We enrolled 716 consecutive cases in this study, but more thanhalf of them did not reveal any abnormalities colonoscopically. RESULTS: Ofthe 716 cases, 48 (7%) were examined by magnifying colonoscopy with a dyespraying technique, following the detection of superficial color changes.Sixteen neoplastic lesions (in 16 cases) were detected among the 48 casesand the detection rate was calculated as 2.2% (16/716) in the total numberof cases and 33% (16/48) in those showing color abnormalities.Histologically, all of the 16 were adenomas. These neoplastic lesions weremost frequent (52%; 11/21) in those showing faint redness in an oval shape,whereas 14 (94%) of the 15 lesions were non-specific in those showing faintredness with unclear margin. CONCLUSIONS: These results may confirm thediagnostic utility of color abnormality, particularly faint redness in anoval shape, for endoscopic screening of superficial colorectal neoplasias.