| Theme | Update on Management of Colorectal Polyp | |
|---|---|---|
| Title | Treatment Strategy for Diminutive Colorectal Polyp -- Standard Strategy in the World | |
| Publish Date | 2019/08 | |
| Author | Yoji Takeuchi | Department of Gastrointestinal Oncology, Osaka International Cancer Institute |
| Author | Satoki Shichijo | Department of Gastrointestinal Oncology, Osaka International Cancer Institute |
| [ Summary ] | Polypectomy for diminutive colorectal polyps (≤5 mm) is not recommended under Japanese guidelines because of rare progressive rate among diminutive colorectal polyps to invasive cancer in a few years. Also the very low incidence of carcinoma among diminutive colorectal polyps and increased risk and cost for polypectomy figure into this recommendation. However, diminutive colorectal polyps can progress to invasive cancer in a few years, although it is rare. The purpose of polypectomy is not only for carcinoma treatment but also for prevention of carcinoma long term. Cold snare polypectomy would not increase the risk of colonoscopies. Additionally, the cost for repeat surveillance is not so different from polypectomy for diminutive colorectal polyps with longer surveillance intervals. Therefore, the reasons why Japanese guidelines do not recommend polypectomy for diminutive polyps are unreasonable. Actually, it is impossible to show the superiority of polypectomy for all detected colorectal polyps compared with polypectomy for only polyps larger than 6 mm, if we cannot conduct a super‒large scale randomized controlled trials. However, removal of possible risks for future colorectal cancer can be theoretically beneficial for the patients with diminutive colorectal polyps. | |