Macroscopic estimation of submucosal invasion in the colon

Colorectal cancer is the third most prevalent cause of cancer-related mortality in Japan, and the incidence of submucosal colorectal cancer is increasing. To reduce colorectal cancer mortality, however, early detection of colorectal cancer is required and adequate diagnosis of depth is needed. Current endoscopes provide high-resolution imaging that result in clear, vivid features of the detected lesions. In particular, when combined with image enhancement, high-magnification endoscopy can provide a detailed analysis of the morphologic architecture of the pit pattern and the capillary pattern in a simple and quick manner. Characteristic colonoscopic findings obtained by a combination of conventional colonoscopy, magnifying chromoendoscopy, and narrow-band imaging are useful for determining the depth of invasion of early-stage colorectal cancers, an essential factor in selecting a treatment modality.