Endoscopy 2012; 44(S 03): SE131-SE139
DOI: 10.1055/s-0032-1309798
Guidelines
© Georg Thieme Verlag KG Stuttgart · New York

European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition – Annotations of colorectal lesions

M. Vieth
1   Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
,
P. Quirke
2   Pathology and Tumour Biology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, United Kingdom
,
R. Lambert
3   Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
,
L. von Karsa
4   Quality Assurance Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
,
M. Risio
5   Pathology Department, Institute for Cancer Research and Treatment, Turin, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
25 September 2012 (online)

Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in pathology was supplemented by an annex describing in greater detail some issues raised in the chapter, particularly details of special interest to pathologists. The content of the annex is presented here to promote international discussion and collaboration by making the issues discussed in the guidelines known to a wider professional and scientific community.

 
  • References

  • 1 Ajioka Y, Watanabe H, Kazama S et al. Early colorectal cancer with special reference to the superficial nonpolypoid type from a histopathologic point of view. World J Surg 2000; 24: 1075-1080
  • 2 Ajioka Y, Watanabe H, Kobayashi M et al. Macroscopic classification of colorectal (minute) neoplasia. I to Cho 1994; 29: 89
  • 3 Borchard F. Forms and nomenclature of gastrointestinal epithelial expansion: what is invasion?. Verh Dtsch Ges Pathol 2000; 84: 50-61
  • 4 Borchard F, Heilmann KL, Hermanek P et al. Definition and clinical significance of dysplasia in the digestive tract. Results of a meeting of the Society of Gastroenterologic Pathology of the German Society of Pathology 25 November 1989 in Kronberg. Pathologe 1991; 12: 50-56
  • 5 Carr NJ, Mahajan H, Tan KL et al. Serrated and non-serrated polyps of the colorectum: their prevalence in an unselected case series and correlation of BRAF mutation analysis with the diagnosis of sessile serrated adenoma. J Clin Pathol 2009; 62: 516-518
  • 6 Cooper HS, Deppisch LM, Gourley WK et al. Endoscopically removed malignant colorectal polyps: clinicopathologic correlations. Gastroenterology 1995; 108: 1657-1665
  • 7 Council of the European Union. Council Recommendation of 2 December 2003 on cancer screening (2003/878/EC). Off J Eur Union; 2003: 34-38
  • 8 Deinlein P, Reulbach U, Stolte M et al. Risk factors for lymphatic metastasis from pT1 colorectal adenocarcinoma. Pathologe 2003; 24: 387-393
  • 9 Farris AB, Misdraji J, Srivastava A et al. Sessile serrated adenoma: challenging discrimination from other serrated colonic polyps. Am J Surg Pathol 2008; 32: 30-35
  • 10 Ferlay J, Shin HR, Bray F et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. [Internet] Lyon, France: International Agency for Research on Cancer; 2010 Available from: http://globocan.iarc.fr Accessed on 05/04/2012
  • 11 Gabbert HE, Meier S, Gerharz CD et al. Tumor-cell dissociation at the invasion front: a new prognostic parameter in gastric cancer patients. Int J Cancer 1992; 50: 202-207
  • 12 Goldstein NS, Bhanot P, Odish E et al. Hyperplastic-like colon polyps that preceded microsatellite-unstable adenocarcinomas. Am J Clin Pathol 2003; 119: 778-796
  • 13 Grady WM, Carethers JM. Genomic and epigenetic instability in colorectal cancer pathogenesis. Gastroenterology 2008; 135: 1079-1099
  • 14 Haggitt RC, Glotzbach RE, Soffer EE et al. Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. Gastroenterology 1985; 89: 328-336
  • 15 Higuchi T, Jass JR. My approach to serrated polyps of the colorectum. J Clin Pathol 2004; 57: 682-686
  • 16 Higuchi T, Sugihara K, Jass JR. Demographic and pathological characteristics of serrated polyps of colorectum. Histopathology 2005; 47: 32-40
  • 17 Hyman NH, Anderson P, Blasyk H. Hyperplastic polyposis and the risk of colorectal cancer. Dis Colon Rectum 2004; 47: 2101-2104
  • 18 Imai T. The growth of human carcinoma: a morphological analysis. Fukuoka Igaku Zasshi 1954; 45: 13-43
  • 19 Jaramillo E, Tamura S, Mitomi H. Endoscopic appearance of serrated adenomas in the colon. Endoscopy 2005; 37: 254-260
  • 20 Jass JR. Classification of colorectal cancer based on correlation of clinical, morphological and molecular features. Histopathology 2007; 50: 113-130
  • 21 Jass JR, Baker K, Zlobec I et al. Advanced colorectal polyps with the molecular and morphological features of serrated polyps and adenomas: concept of a “fusion” pathway to colorectal cancer. Histopathology 2006; 49: 121-131
  • 22 Jass JR, Love SB, Northover JM. A new prognostic classification of rectal cancer. Lancet 1987; 1: 1303-1306
  • 23 Kawasaki T, Ohnishi M, Nosho K et al. CpG island methylator phenotype-low (CIMP-low) colorectal cancer shows not only few methylated CIMP-high-specific CpG islands, but also low-level methylation at individual loci. Mod Pathol 2008; 21: 245-255
  • 24 Kobayashi M, Watanabe H, Maeo S et al. Correlation of histological atypia and cancer-sprouting with vascular permeation and lymph nodal metastasis by our new histological classification of submucosal invasion by colorectal carcinomas. Stomach Intest 1994; 29: 1151-1156
  • 25 Konishi F, Morson BC. Pathology of colorectal adenomas: a colonoscopic survey. J Clin Pathol 1982; 35: 830-841
  • 26 Kudo S, Lambert R, Allen JI et al. Nonpolypoid neoplastic lesions of the colorectal mucosa. Gastrointest Endosc 2008; 68: 3-47
  • 27 Lambert R, O'Brien MJ, Jaramillo E et al. The serrated pathway to colorectal cancer. World Gastroenterology News 2009; 14: 5-10
  • 28 Leggett BA, Devereaux B, Biden K et al. Hyperplastic polyposis: association with colorectal cancer. Am J Surg Pathol 2001; 25: 177-184
  • 29 Liebig C, Ayala G, Wilks J et al. Perineural invasion is an independent predictor of outcome in colorectal cancer. J Clin Oncol 2009; 27: 5131-5137
  • 30 Liebig C, Ayala G, Wilks JA et al. Perineural invasion in cancer: a review of the literature. Cancer 2009; 115: 3379-3391
  • 31 Longacre TA, Fenoglio-Preiser CM. Mixed hyperplastic adenomatous polyps/serrated adenomas. A distinct form of colorectal neoplasia.. Am J Surg Pathol 1990; 14: 524-537
  • 32 Marshall CL, Liebig C, Wilks J et al. Reply to E.M. Poeschl et al. J Clin.Oncol 2010;
  • 33 Minozzi S, Armaroli P, Banzi R et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis - First edition. Appendix 1: Systematic evidence review. 2010. http://bookshop.europa.eu/en/european-guidelines-for-quality-assurance-in-colorectal-cancer-screening-and-diagnosis-pbND3210390/ Accessed 11/2/2012
  • 34 Minozzi S, Armaroli P, Segnan N. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Principles of evidence assessment and methods for reaching recommendations. Endoscopy 2012; 44: SE9-SE14
  • 35 Montgomery E. Serrated colorectal polyps: emerging evidence suggests the need for a reappraisal. Adv Anat Pathol 2004; 11: 143-149
  • 36 Nakamura T, Mitomi H, Kanazawa H et al. Tumor budding as an index to identify high-risk patients with stage II colon cancer. Dis Colon Rectum 2008; 51: 568-572
  • 37 Nascimbeni R, Burgart LJ, Nivatvongs S et al. Risk of lymph node metastasis in T1 carcinoma of the colon and rectum. Dis Colon Rectum 2002; 45: 200-206
  • 38 NHS Bowel Cancer Screening Programme. Reporting lesions in the NHS Bowel Cancer Screening Programme – guidelines from the Bowel Cancer Screening Programme Pathology Group. 2007 http://www.cancerscreening.nhs.uk/bowel/publications/nhsbcsp01.pdf Accessed 11/2/2012
  • 39 Noffsinger AE. Serrated polyps and colorectal cancer: new pathway to malignancy. Annu Rev Pathol 2009; 4: 343-364
  • 40 OʼBrien MJ. Hyperplastic and serrated polyps of the colorectum. Gastroenterol Clin North Am 2007; 36: 947-68 viii
  • 41 OʼBrien MJ, Yang S, Huang CS et al. The serrated polyp pathway to colorectal carcinoma. Diagnostic Histopathology 2008; 14: 78-93
  • 42 Ogawa T, Yoshida T, Tsuruta T et al. Tumor budding is predictive of lymphatic involvement and lymph node metastases in submucosal invasive colorectal adenocarcinomas and in non-polypoid compared with polypoid growths. Scand J Gastroenterol 2009; 44: 605-614
  • 43 Ogino S, Goel A. Molecular classification and correlates in colorectal cancer. J Mol Diagn 2008; 10: 13-27
  • 44 Ogino S, Kawasaki T, Kirkner GJ et al. Evaluation of markers for CpG island methylator phenotype (CIMP) in colorectal cancer by a large population-based sample. J Mol Diagn 2007; 9: 305-314
  • 45 Ogino S, Kawasaki T, Kirkner GJ et al. CpG island methylator phenotype-low (CIMP-low) in colorectal cancer: possible associations with male sex and KRAS mutations. J Mol Diagn 2006; 8: 582-588
  • 46 Ogino S, Nosho K, Kirkner GJ et al. CpG island methylator phenotype, microsatellite instability, BRAF mutation and clinical outcome in colon cancer. Gut 2009; 58: 90-96
  • 47 Oka S, Tanaka S, Hiyama T et al. Clinicopathologic and endoscopic features of colorectal serrated adenoma: differences between polypoid and superficial types. Gastrointest Endosc 2004; 59: 213-219
  • 48 Oono Y, Fu K, Nakamura H et al. Progression of a sessile serrated adenoma to an early invasive cancer within 8 months. Dig Dis Sci 2009; 54: 906-909
  • 49 Owens SR, Chiosea SI, Kuan SF. Selective expression of gastric mucin MUC6 in colonic sessile serrated adenoma but not in hyperplastic polyp aids in morphological diagnosis of serrated polyps. Mod Pathol 2008; 21: 660-669
  • 50 Poeschl EM, Pollheimer MJ, Kornprat P et al. Perineural Invasion: Correlation With Aggressive Phenotype and Independent Prognostic Variable in Both Colon and Rectum Cancer. J Clin Oncol 2010;
  • 51 Quirke P, Risio M, Lambert R et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis: Chapter 7 – Quality assurance in pathology in colorectal cancer screening and diagnosis. Endoscopy 2012; 44: SE116-SE130
  • 52 Samowitz WS, Slattery ML, Sweeney C et al. APC mutations and other genetic and epigenetic changes in colon cancer. Mol Cancer Res 2007; 5: 165-170
  • 53 Sandmeier D, Seelentag W, Bouzourene H. Serrated polyps of the colorectum: is sessile serrated adenoma distinguishable from hyperplastic polyp in a daily practice?. Virchows Arch 2007; 450: 613-618
  • 54 Schlemper RJ, Kato Y, Stolte M. Diagnostic criteria for gastrointestinal carcinomas in Japan and Western countries: proposal for a new classification system of gastrointestinal epithelial neoplasia. J Gastroenterol Hepatol 2000; 15: 49-G57
  • 55 Schlemper RJ, Kato Y, Stolte M. Review of histological classifications of gastrointestinal epithelial neoplasia: differences in diagnosis of early carcinomas between Japanese and Western pathologists. J Gastroenterol 2001; 36: 445-456
  • 56 Schlemper RJ, Riddell RH, Kato Y et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut 2000; 47: 251-255
  • 57 Schmiegel W, Reinacher-Schick A, Arnold D et al. Update S3-guideline “colorectal cancer” 2008. Z Gastroenterol 2008; 46: 799-840
  • 58 Schreiner MA, Weiss DG, Lieberman DA. Proximal and large hyperplastic and nondysplastic serrated polyps detected by colonoscopy are associated with neoplasia. Gastroenterology 2010; 139: 1497-1502
  • 59 Segnan N, Patnick J, von Karsa L (eds.) European guidelines for quality assurance in colorectal cancer screening and diagnosis - First edition. Luxembourg: European Commission, Publications Office of the European Union; 2010
  • 60 Shen L, Toyota M, Kondo Y et al. Integrated genetic and epigenetic analysis identifies three different subclasses of colon cancer. Proc Natl Acad Sci U S A 2007; 104: 18654-18659
  • 61 Sheridan TB, Fenton H, Lewin MR et al. Sessile serrated adenomas with low- and high-grade dysplasia and early carcinomas: an immunohistochemical study of serrated lesions “caught in the act”. Am J Clin Pathol 2006; 126: 564-571
  • 62 Snover DC, Jass JR, Fenoglio-Preiser C et al. Serrated polyps of the large intestine: a morphologic and molecular review of an evolving concept. Am J Clin Pathol 2005; 124: 380-391
  • 63 Spring KJ, Zhao ZZ, Karamatic R et al. High prevalence of sessile serrated adenomas with BRAF mutations: a prospective study of patients undergoing colonoscopy. Gastroenterology 2006; 131: 1400-1407
  • 64 Suehiro Y, Wong CW, Chirieac LR et al. Epigenetic-genetic interactions in the APC/WNT, RAS/RAF, and P53 pathways in colorectal carcinoma. Clin Cancer Res 2008; 14: 2560-2569
  • 65 Sy J, Fung CL, Dent OF et al. Tumor budding and survival after potentially curative resection of node-positive colon cancer. Dis Colon Rectum 2010; 53: 301-307
  • 66 Torlakovic E, Skovlund E, Snover DC et al. Morphologic reappraisal of serrated colorectal polyps. Am J Surg Pathol 2003; 27: 65-81
  • 67 Torlakovic E, Snover DC. Serrated adenomatous polyposis in humans. Gastroenterology 1996; 110: 748-755
  • 68 Torlakovic EE, Gomez JD, Driman DK et al. Sessile serrated adenoma (SSA) vs. traditional serrated adenoma (TSA). Am J Surg Pathol 2008; 32: 21-29
  • 69 Toyota M, Ahuja N, Ohe-Toyota M et al. CpG island methylator phenotype in colorectal cancer. Proc Natl Acad Sci U S A 1999; 96: 8681-8686
  • 70 Toyota M, Ohe-Toyota M, Ahuja N et al. Distinct genetic profiles in colorectal tumors with or without the CpG island methylator phenotype. Proc Natl Acad Sci U S A 2000; 97: 710-715
  • 71 Ueno H, Mochizuki H, Hashiguchi Y et al. Risk factors for an adverse outcome in early invasive colorectal carcinoma. Gastroenterology 2004; 127: 385-394
  • 72 Vieth M, Quirke P, Lambert R et al. Annex to Quirke et al. Quality assurance in pathology in colorectal cancer screening and diagnosis: annotations of colorectal lesions. Virchows Arch 2011; 458: 21-30
  • 73 Vieth M, Stolte M. Distinction of high-grade intraepithelial neoplasia and tubular gastric adenocarcinoma. In: Kaminishi M, Takubo K, Mafune K, (eds.) The diversity of gastric carcinoma: pathogenesis, diagnosis and therapy. Tokyo: Springer; 2005: 109-116
  • 74 Volk EE, Goldblum JR, Petras RE et al. Management and outcome of patients with invasive carcinoma arising in colorectal polyps. Gastroenterology 1995; 109: 1801-1807
  • 75 von Karsa L, Anttila A, Ronco G et al. Cancer Screening in the European Union. Report on the implementation of the Council Recommendation on Cancer Screening – First Report. Luxembourg: European Commission; 2008 http://ec.europa.eu/health/archive/ph_determinants/genetics/documents/cancer_screening.pdf Accessed 11/2/2012
  • 76 von Karsa L, Lignini TA, Patnick J et al. The dimensions of the CRC problem. Best Pract Res Clin Gastroenterol 2010; 24: 381-396
  • 77 Washington MK, Berlin J, Branton P et al. Protocol for the examination of specimens from patients with primary carcinoma of the colon and rectum. Arch Pathol Lab Med 2009; 133: 1539-1551
  • 78 Watanabe H, Suda T. Precancerous lesions of the colon and rectum. Gan To Kagaku Ryoho 1984; 11: 1-9
  • 79 WHO. Pathology and genetics of tumours in the digestive system. Carcinoma of the colon and rectum. In: Hamilton SR, Aaltonen LA, (eds.) World Health Organization International Histological Classification of Tumours. Lyon: IARC Press; 2000: 105-119
  • 80 Williams GT, Quirke P, Shepherd NA. Dataset for colorectal cancer. 2007 2nd. edition http://www.rcpath.org/resources/pdf/G049-ColorectalDataset-Sep07.pdf Accessed 11/2/2012
  • 81 Williams GT, Quirke P, Shepherd NA. Dataset for colorectal cancer - Appendix C: Proforma for colorectal cancer resections. 2007 2nd. edition http://www.rcpath.org/resources/worddocs/G049ColorectalDatasetAppendixC-Sep07.doc Accessed 11/2/2012
  • 82 Williams GT, Quirke P, Shepherd NA. Dataset for colorectal cancer – Appendix D: Proforma for local excision specimens. 2007 2nd. edition http://www.rcpath.org/resources/worddocs/G049ColorectalDatasetAppendixD-Sep07.doc Accessed 11/2/2012
  • 83 Wilson JM, Jungner YG. Principles and practice of mass screening for disease. World Health Organization; 1968 http://whqlibdoc.who.int/php/WHO_PHP_34.pdf Accessed 11/2/2012
  • 84 Wolber RA, Owen DA. Flat adenomas of the colon. Hum Pathol 1991; 22: 70-74
  • 85 Wong NA, Hunt LP, Novelli MR et al. Observer agreement in the diagnosis of serrated polyps of the large bowel. Histopathology 2009; 55: 63-66