Eastern and Western perspectives

Early Colorectal Cancer Diagnosis


Why this course?

In the real-world a screening colonoscopist diagnoses many polyps. Only 5% of them progress to cancer. So how to identify them? Just like surgeons and oncologists, the endoscopist should carry on imaging diagnosis of all suspected lesions to inform clinical decision on most appropriate therapy. Taken together, polyp appearance, morphologic classification and IEE-based characterization of surface and vessel pattern allow to estimate the depth of invasion.

However, endoscopic diagnosis of early CRC is not always straightforward. Acquisition of cognitiveperceptual skills takes time. In some cases, despite the use of magnifying scopes and dyes, the diagnosis remains difficult cautioning decision-making.

Early CRC management in Japan is a showcase of expert thought process – how experts solve complex problems in the real world. In Japan, the histologic definition of early cancer is an umbrella term, i.e. high-grade intramucosal neoplasia (HGIN) comprising HGD, Tis and superficial smi, with en-bloc resection being the basic principle for ensuring comprehensive pathological assessment.

Because ESD preserves organ anatomy with benefits outweighing the potential risks when appropriately carried out, ESD is the preferred resection method.

Japan NBI Expert Team (JNET) Classification of colorectal polyps embodies along with well-known types, a new entity – type 2B that corresponds to the umbrella term (HGIN) thus aligning histologic and endoscopic definitions and expanding the window of opportunity for ESD. These insights emerged from several decades of technological progress forming the engine for continuing innovation in endoscopy.

The current course aims to transfer cognitive-perceptual knowledge and clinical decision-making skills regarding most suitable resection method – the best of Eastern and Western perspectives. On the other hand, our teaching method is based on decades of research in expert decision making in various fields of science, engineering, healthcare, also known as Science of Expertise, and a bit on our teaching experience.

We hope that you will enjoy!

Course Directors

Silvia Sanduleanu (Netherlands)

*Participation is free but mandatory by selecting the course in the registration form.

**Please note that to register for the course, you must also register for the workshop.