Prevalence of advanced histological features in diminutive and small colon polyps

Background Investigators have proposed “predict, resect, and discard” strategies for diminutive (≤5 mm) or small (6-9 mm) polyps to reduce screening colonoscopy costs. Advanced histological features such as villous histology, high-grade dysplasia, and/or cancer in these polyps could deter adoption o...

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Bibliographic Details
Published in:Gastrointestinal endoscopy 2012-05, Vol.75 (5), p.1022-1030
Main Authors: Gupta, Neil, MD, MPH, Bansal, Ajay, MD, Rao, Deepthi, MD, Early, Dayna S., MD, Jonnalagadda, Sreenivasa, MD, Wani, Sachin B., MD, Edmundowicz, Steven A., MD, Sharma, Prateek, MD, Rastogi, Amit, MD
Format: Article
Language:English
Subjects:
Adenoma - pathology
Adenoma, Villous - pathology
Biological and medical sciences
Colonic Neoplasms - pathology
Colonic Polyps - pathology
Colonic Polyps - surgery
Colonoscopy
Digestive system. Abdomen
Endoscopy
Female
Gastroenterology and Hepatology
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Retrospective Studies
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tumor Burden
Tumors
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Summary:Background Investigators have proposed “predict, resect, and discard” strategies for diminutive (≤5 mm) or small (6-9 mm) polyps to reduce screening colonoscopy costs. Advanced histological features such as villous histology, high-grade dysplasia, and/or cancer in these polyps could deter adoption of these strategies. Objective Determine the prevalence of advanced histological features in diminutive and small colon polyps. Design Retrospective analysis of data from 3 prospective clinical trials. Setting Two tertiary-care referral centers. Patients This study involved patients undergoing screening or surveillance colonoscopy. Intervention The location, size, and morphology of each polyp detected was documented. Each polyp was then resected, placed in a unique specimen jar, and sent for histopathological evaluation. Main Outcome Measurements Rates of advanced histological features (villous histology, high-grade dysplasia, and cancer). Results A total of 2361 polyps were detected, removed, and retrieved. Both diminutive and small polyps had a lower frequency of any advanced histological features compared with large polyps (0.5% and 1.5%, respectively vs 15.0%; P < .001 for both comparisons). Polyps
ISSN:0016-5107
1097-6779
DOI:10.1016/j.gie.2012.01.020