Which Polyps Should Result in Referral for Colonoscopy?

Which polyps detected by computed tomography colonography (CTC) should result in referral for colonoscopy? Opinions vary. A recent multidisciplinary guideline recommended that patients with polyps ≥6 mm be offered colonoscopy and polypectomy. The American College of Radiology recommends that patients with only one or two 6- to 9-mm polyps (and no other, larger polyps) can be offered CTC surveillance (with repeat CTC in 3 years) rather than polypectomy. However, few studies have examined rates of advanced histology based on the size of detected polyps.

To fill this knowledge gap, investigators reviewed colonoscopy data from 17 U.S. practices in the Clinical Outcomes Research Initiative (CORI) repository and classified patients by the size of …