title: International and inter-observer differences in macroscopic classification of superficial early colorectal cancer.
abstract: OBJECTIVE
  The aim of this research is to investigate the international and intra-observer differences in the macroscopic classification of early colorectal cancer between Japan and China.
  
  
  METHODS
  Color pictures of 9 cases of early colorectal cancer were distributed to 6 Japanese and 5 Chinese endoscopists. After reviewing the pictures, the doctors made their classificatory diagnoses independently and indicated their findings on which the diagnoses were based.
  
  
  RESULTS
  There was some consistency in the classification of distinctly elevated lesions among all the Japanese and Chinese endoscopists. However, some elevated lesions classified as type II in Japan might be diagnosed as type I by Chinese endoscopists. For superficial lesions consisting of elevation plus central depression, IIa+IIc or IIc+IIa, were classified according to the ratio of elevation and depression. Although international difference is not significant, inter-observer differences still exist in classifying these lesions. In addition, the differences in laterally spreading tumor were mainly due to terminology.
  
  
  CONCLUSIONS
  Japanese and Chinese doctors share a lot of similarities in the classification of flat elevated lesions; however, both international and inter-observer differences still exist in the macroscopic classification for early CRC.
authors.affiliation: Department of Gastroenterology, Fujita Health University, Toyoake, Aichi, Japan. ihirata@fujita-hu.ac.jp
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hirata
authors.forename: Fang-Yu
authors.initials: FY
authors.lastname: Wang
authors.forename: Mitsuyuki
authors.initials: M
authors.lastname: Murano
authors.forename: Takuya
authors.initials: T
authors.lastname: Inoue
authors.forename: Ken
authors.initials: K
authors.lastname: Toshina
authors.forename: Kentaro
authors.initials: K
authors.lastname: Maemura
authors.forename: Renmin
authors.initials: R
authors.lastname: Zhu
authors.forename: Shudong
authors.initials: S
authors.lastname: Xiao
mesh_terms: D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000145:classification* / Q000473:pathology*; D006801:Humans; D015588:Observer Variation