Challenging diagnostic issues in adenomatous polyps with epithelial misplacement in bowel cancer screening: 5 years' experience of the Bowel Cancer Screening Programme Expert Board.

摘要: The diagnostic difficulties of differentiating epithelial misplacement from invasive cancer in colorectal adenomatous polyps have been recognised for many years. Nevertheless, the introduction population screening UK has resulted extraordinary problems. Larger sigmoid colonic polyps, which are those most likely to show misplacement, specifically selected into such programmes, because these bleed and is based on detection occult blood. challenges associated with this particular phenomenon necessitated institution an 'Expert Board': a review first five years its practice, during time 256 249 patients assessed. Indeed, Expert Board contains three pathologists, pathologists do not necessarily agree, consensus diagnosis required drive appropriate patient management. However, study shown substantial levels agreement between whereby ultimate changed, that original referral diagnosis, by half all majority malignant benign. In 3% polyp cases, dual both adenocarcinoma, further illustrating difficulties. Bowel Cancer Screening Programme represents unique successful development response conundrum created characteristics bowel screening.