Clinical decision support

Submucosal invasion risk calculator

Stratify covert invasive cancer risk in large colorectal lesions using endoscopic morphology and imaging features.

Intended population

Colon polyps measuring 20 mm or larger, assessed before resection.

Assessment

Lesion characteristics

Is there a demarcation area (regular → irregular pit / vascular pattern) within the polyp?

Clinical disclaimer

This is a decision-support estimate, not a substitute for clinical judgement. It does not replace histopathology or specialist assessment.

Definitions

Demarcation area — area within a colorectal polyp where a regular pit / vascular pattern becomes disordered (e.g. NICE II→III, Kudo III/IV→V, JNET 2A→2B/3).

Reference & attribution

Burgess NG, Hourigan LF, Zanati SA, et al. Risk Stratification for Covert Invasive Cancer Among Patients Referred for Colonic Endoscopic Mucosal Resection: A Large Multicenter Cohort. Gastroenterology 2017;153(3):732–742.e1.

Score adapted for GIEQs.com by David Tate.

With thanks to Nick Burgess for supplying the original study data.