Diagnosis and Treatment of Diminutive Polyps in the Colon

AbstractPurpose of reviewColonoscopy and polypectomy reduce the incidence and mortality of colorectal cancer (CRC) by detecting and removing colorectal adenomas. Diminutive polyps (1 –5 mm) account for 75% of all polyps found but rarely contain or progress to CRC. Although a high adenoma detection rate (ADR) is associated with improved cancer prevention, the increase in detection of diminutive polyps also increases costs associated with CRC prevention programs. This review pr ovides an update on endoscopic management and considerations related to diminutive colorectal polyps.Recent findingsRecent studies show that only 0 –4.3% of diminutive polyps show advanced features and progression into CRC is extremely rare. Advances in endoscopic imaging have improved the ADR for screening colonoscopy, mostly as a result of greater detection of diminutive and hyperplastic polyps. A resect and discard strategy for these low-r isk diminutive polyps could reduce the need for pathologic assessment and is included in society guidelines with recommendations on imaging modalities, classification, and endoscopist benchmarks. To ensure complete resection, cold snare polypectomy is emerging as the most efficient and safest method of removal. A recent guideline review showed that fecal immunochemical testing is generally the preferred first-line screening test in average-risk adults. Post-polypectomy surveillance intervals may increase in the future as evidence on the management and outcomes ...
Source: Current Treatment Options in Gastroenterology - Category: Gastroenterology Source Type: research