Endoscopic Assessment of the Malignant Potential of the Nonpolypoid (Flat and Depressed) Colorectal Neoplasms: Thinking Fast, and Slow

Ravishankar Asokkumar, Carmel Malvar, Tiffany Nguyen-Vu, Silvia Sanduleanu, Tonya Kaltenbach, Roy Soetikno*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Current endoscopy training methodology does not meet the learning traits, skills, and needs of the newer generation of gastroenterologists. This article provides information on assessment of the malignant potential of colorectal neoplasms. It takes a modern approach on the topic and integrates relevant information that aligns with the thinking process. The theory of thinking fast (reflex) and slow (rational) is used. By doing so, it is hoped that the learning process can be expedited and practiced immediately. The focus is on preresection assessment of nonpolypoid colorectal neoplasms. Assessment of polypoid, sessile-serrated adenoma/polyp, or inflammatory bowel disease dysplasia is briefly discussed.

Original languageEnglish
Pages (from-to)613-628
Number of pages16
JournalGastrointestinal Endoscopy Clinics of North America
Issue number4
Publication statusPublished - Oct 2019


  • Adenocarcinoma/pathology
  • Clinical Competence
  • Colonic Polyps/pathology
  • Colonoscopy/methods
  • Colorectal Neoplasms/diagnosis
  • Female
  • Gastroenterology/education
  • Humans
  • Intestinal Mucosa/pathology
  • Male
  • Minimally Invasive Surgical Procedures/methods
  • Neoplasm Invasiveness/pathology
  • Neoplasm Staging
  • Patient Safety

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