Do Tiny Polyps Detected During Imaging Warrant Colonoscopy?

Controversy exists about which patients should undergo colonoscopy and polypectomy after detection of polyps <1 cm in size by imaging techniques. The American College of Gastroenterology recommends that patients with polyps ≥6 mm be referred for polypectomy, whereas the American College of Radiology recommends offering computed tomographic (CT) colonography surveillance to these patients. To investigate this issue further, researchers assessed risk factors for advanced neoplasia in polyps <1 cm using a national colonoscopy database in Bavaria, Germany.

In 1,077,956 colonoscopies, 106,270 intermediate (5–9 mm) and 198,954 diminutive (≤4 mm) lesions were identified. Advanced neoplasia was present in 13% of intermediate and 3.7% of diminutive l…