2. Concept of Diagnosis of Early Cancer of the Colon

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Early cancer of the colon is defined that invasion of cancer is limited to mucosa and submucosa of the colon. For diagnosing early cancer of the colon, small lesion, even less than 1cm, should be detected at the first X-ray examination, and the lesion more than 1cm should not be missed. To estimate frontal and profile view of radiograph of the lesion, it is possible to assign malignancy, however, final diagnosis should be made by endoscopic biopsy.<BR>Hojo reported relation between malignancy and size of colonic polyp i.e. malignancy of colonic polyp proportionally increases according to its size. 32 to 50% of colonic polyp larger than 2 cm in diameter are cancer or so-called "carcinoma-in-situ".<BR>Maruyama reported that stalk of colonic polyp should be definitely demonstrated on the radiograph, because polyp with stalk is benign lesion or early cancer. And a depression on the surface of the lesion without stalk is indicative for early or advanced cancer.<BR>The fact that in the majority of flat elevated lesion, cancer infiltrates submucosa already, should be specially noticed.
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