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With great interest, we have read the article by Backes et al,1 on the pre-resection accuracy of the real-time optical diagnosis of T1 colorectal cancer (T1CRC) in large non-pedunculated colorectal polyps. In this multicentre, prospective study, the authors developed and validated the OPTICAL model, in which a sensitivity of 78.7% (95% CI: 64.3 to 89.3) for optical diagnosis of T1CRC was obtained.
With the implementation of the Dutch bowel cancer screening programme (BCSP) in 2014, a shift has occurred towards the more frequent diagnoses of early AJCC (American Joint Committee on Cancer) stage I cancers.2 Estimating the risk of a T1CRC is crucial to determine the optimal treatment strategy, and to select cases for more elaborative and expensive endoscopic en bloc resection techniques such as endoscopic submucosal dissection, transanal minimally invasive surgery or endoscopic full-thickness resection. Current studies mainly report on the outcomes of advanced imaging by expert centres with dedicated endoscopists,3 4 whereas …
LWTM and AJPvdW contributed equally.
Contributors LWTM: study concept, data collection, data analysis and interpretation, writing letter. AJPvdW: data collection, data analysis and interpretation, writing letter. M-ED: data collection. ZM: constructive review of the letter. AAMM: data interpretation, constructive review of the letter. LWTM and AJPvdW contributed equally to this letter. All authors approved the final letter.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests AAMM reports grants from Dutch Cancer Society, from Pentax Medical (Europe GmbH), and from ZON MW Netherlands, outside the submitted work.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.