Colonic polyps: are we ready to resect and discard?

Abstract

Colorectal cancer represents a major cause of mortality in Western countries, and population-based colonoscopy screening is supported by official guidelines. A significant determinant of the cost of colonoscopy screening/surveillance is driven by polypectomy of diminutive (≤5 mm) lesions. When considering the low prevalence of advanced neoplasia within diminutive polyps, the additional cost of pathologic examination is mainly justified by the need to differentiate between precancerous adenomatous versus hyperplastic polyps. The aim of this review is to summarize the data supporting the clinical application of a resect and discard strategy, also addressing the potential pitfalls associated with this approach.