Radiologists, gastroenterologists disagree about need to remove small colon polyps

December 11, 2008 Diagnostic Imaging. Radiologists, gastroenterologists disagree about need to remove small colon polyps By H.A. Abella Recommendations from an Oregon Health and Science Center study have clashed with the findings from a University of Wisconsin trial on the value of polypectomy for small polyps identified during CT colonography. The Oregon study calls for immediate resection while the Wisconsin trial concludes that removal would be costly, risky, and, by definition, unnecessary. The clinical literature shows the detection and treatment of colorectal cancer has become a significant economic burden. Though accurate for colorectal cancer screening, gold standard colonoscopy has drawn low compliance rates, mostly due to its invasiveness. CTC has emerged as a highly sensitive exam for detection of suspicious lesions and has been included by the American Cancer Society as an alternative, noninvasive screening test. Studies have already shown that polypectomy of lesions 5 mm and smaller detected at CTC is not cost-effective. The clinical management of small polyps 6 to 9 mm in diameter, on the other hand, remains controversial.

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