Colorectal
Signal score, how each part rates
ActionabilityPrevalenceStakesEvidence strengthNovelty
See the full rubric →Inter and intra-observer agreement for the LST Classification in Large (>2cm) Colorectal Laterally Spreading Tumours.
Clinical takeawayThe full LST subtype system has only fair inter-observer reliability (kappa about 0.36) versus moderate (about 0.48) for a simplified granular vs non-granular split, so weight the reproducible split but still document the high-risk nodular-mixed and pseudodepressed features, since guidelines use them to select en-bloc resection or ESD.
What it foundInter-observer agreement for LST classification was poor (κ=0.37 first round, κ=0.36 second round), improving to moderate (κ≈0.48) with a simplified 3-category granular vs non-granular model.
ContextChallenges current reliance on detailed LST subclassification, which lacks standardized reliability despite widespread use in predicting submucosal invasion risk and resection strategy.
Emergingsuggested applicable standard· U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017
Decision at stakethe morphological assessment of large colorectal laterally spreading tumors for predicting submucosal invasion risk
U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017 · reviewed 2026-07-23 ↗Begin average-risk colorectal cancer screening at age 45 using a patient-centered shared-decision modality choice, colonoscopy every 10 years (preferred) or annual FIT as Tier 1 options, with multi-target stool DNA every 3 years, CT colonography every 5 years, or flexible sigmoidoscopy every 5 to 10 years as Tier 2 alternatives. A positive stool-based test requires diagnostic colonoscopy, and stool tests should not be ordered for patients who would decline follow-up colonoscopy. Generally stop at age 75 with individualized decisions for ages 76-85 and no screening beyond 85.
Djinbachian R … Pioche M · American Journal of Gastroenterology · IF 14.9 · PubMed ↗